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:_Waste Tire S . /ey & Inspection Repot SURVEY REQUIRED11 <br /> •'-`• State of Califomia <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - i _ Q 1 Inspection 1 _ -1 J- <br /> Site Suffix: t Report I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> t�LS _ Q,j_�-f i i(nu c- 1_S s PA NAJ <br /> 11�U� kC Nll_ tDf(�s Se/1v1 U. -bu4C-r- <br /> - wv `t s � 15� eA ��a4e��i 14 <br /> 14 r <br /> 3 � rq-- m 6-, 7fc- 5 ��LO�) 1 A Q 4WA� <br /> � . ' <br /> n- <br /> 1K ruls - <br /> �i r <br /> � <br /> �� WSJ , pfd 5�(�rrS d15(,tllSs�- <br /> 42408 <br /> � � � n14PL � T � 3 <br /> t � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />