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Waste Tire vey & Inspection RI, * LSURVIEYREQUIRED] <br /> •••��! St ate of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- j 11 c_ Inspection <br /> Site Suffix: co �1 / —z— Report = I — I Z 41 <br /> 1 ` Number: I <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Lj <br /> 21.E <br /> AAJZ <br /> �) CAA 5. La mt.ab <br /> 42408 <br /> JE XIA MJPILIEI 1112131 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA Ed <br />