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Waste Tire S vey & Inspection Rej SURVEY REQUIRED ■ <br /> State of California <br /> CIWMB 183 (/Jew 04/04) <br /> Comments Form — <br /> - <br /> CalifornialntegratedWasteManagementBoard BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> Ste SufflX: 2 �J - Report = J~ 1 <br /> ' ....J � 3 � [ � � � Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> 'Y)ce <br /> �O C..S des <br /> < ^t <br /> UTI (1 r f)n,, a s o2 C�t.11,P✓S <br /> -N4- �oG n i FT Mr c ISD!' ~t- S- lL <br /> Cyl a'' c- 4tn= Z- <br /> "7'YS.y <br /> A .) <br /> 11 <br /> c oe-rci,•- I <br /> / wt, nn my i 40c�� Ir_ <br /> dAc� <br /> c j<-- <br /> -- <br /> A LT 2—JE � 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA • <br />