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Waste Tire Sl rey & Inspection Rep l SURVEY REQUIRED <br /> State of California --- <br /> CIWMB183 (New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Q U i Inspection <br /> Site Suffix: 5 1 1 (f) 1 Report I 1 — ` 2 1 d 3 2 2 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> CA-k c-NNzz 7t -Tvfl Ceck, ca�2 <br /> 73 A)o MS cLc,��%YA7tf �� c S �c�c�lt i ��,r•c <br /> J), or�c'1�s - caste "p V. Vj <br /> yo VC-ttS �Cc-oyvn <br /> 44 <br /> jr <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />