Ripples on the top layer back and left of plate

I keep having a problem where the top layer of my print gets ripples, and it’s always on the left and back of the plate. I’ve added extra round shapes on the first player to help with bed adhesion. I’ve cleaned the bed with dish soap and alcohol. I’ve tried both textured and smooth beds. I’ve done manual extrusion tuning. I’ve even added clips to ensure the bed isn’t being pulled up. I always have auto bed leveling enabled, and I recently did a very careful manual tramming. Nothing I do helps. Any idea what’s going on here?