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Waste Tire S. rey & Inspection Rep <br /> SURVEY REQUIRED 'i ■ <br /> State of California <br /> yy CIWMB 183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> SPe Suffix: I 1 Report I — 3 5 <br /> ` Number: ` <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> rlL:M 60 . <br /> �7 <br /> F-('�_A T __c2c-) 1-0-n t <br /> -r,��q+-C, a�-� ' �-(tai-t 54r /0-_06q_l <br /> 42408 <br /> _ �� <br /> � AF � 3 ® ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />