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■ :.- a 9 -TI-rE�-- a�� ac—InS_�_ec0e _�e- t -SURVEY-REQUIRED <br /> .e ....c. Stateof 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 - I 7 ` y 2 - Inspection _ q 6 5 2- 9 <br /> Site Suffix: �'1 / ® 1 Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> low <br /> -- i <br /> e_ce. <br /> -- I <br /> JE XIA MIPILIE1 111273 <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />