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_= Waste Tire S( fey & Inspection Rep 't L SURVEY REQUIRED) <br /> i•! -,= Stateof 83(New Comments Form <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - Inspection <br /> Site ` I 7 O <br /> Site Suffix: � � / 55 3 d 7 e (� ' Report I � _ Z l <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �sz�es`. 1•, �C �G�c .�c~.csx vS .�n <br /> Cov�n��e <br /> ZMn gar <br /> oo& <br /> S. c c 0.VNv -wc`s �;c�S cQneca <br /> CA :SNoCaL��Oh . <br /> 42408 <br /> JE XIA M PIL. 123 <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />