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:'-A_ Waste Tire SL _ ey & Inspection Rep SURVEY REQUIRED ■ <br /> ••"-•• State of California <br /> CIWMB183 (New 04104) Comments Form - <br /> California Integrated Waste Management Board _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - ' , t I i *� - 0 Inspection _ n <br /> Site Suffix: ` `�, 1 Report z :1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> cS'• 1 u�V1 �11,(ss S � �e � <br /> ,j <br /> �. <br /> 3 VCGn <br /> c. KILOS 1 _ <br /> A A, <br /> - <br /> 1 i <br /> �► ?�e.5 S 11) <br /> � <br /> licm Is, <br /> S�-� f�� CODJ <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />