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r Waste Tire .y & Inspection Re" SURVEY REQUIRED <br /> 7.::.:.a. State of California - -- -- <br /> ___-__ Comments Form <br /> $;�{ CIWM6183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile _Inspection Details <br /> TPID- - _ — Inspection <br /> tt ( Report I - C) : C) G <br /> Site Suffix: i �1 �l L t d j Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> [_ <br /> Commentsw 1 t° y { .""� �"by.t'`,l" %" ., v.ry„e', ,{.ay+,,vy' ra ,yag,,,afir, "d" Y`'3:�J,'m„✓Mr4.aer.veM . <br /> IF <br /> — _ane c_r <br /> • € ��Y C.`��Y� --C{-s,t.Cl-'n-��-T t P~:. ��'T' � ���t��ry� t ,_T r <�tes� ac-E' �#d <br /> — <br /> _u_�_ }s r,n A si 0 , Y-e On-�p <br /> CSCo - <br /> JE A 1 „ 2 3 :2408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />