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Waste Tire fey & Inspection Re, SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ) y y 0 Q / Q Report I — f '7 <br /> Number: r <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> / _.f ErY ICA — <br /> --�-� ��%S U rte- C�f�UYI � • -�-��Y�- --C�.� �fes! <br /> �t �'�%_ C'rra�xcL—�.rCt/�/"��G�•r� � t/�r� �if��_v,.� <br /> `-wl 3 to ecl C-1),7 S/ YVi i( loe cAl,_ <br /> �) D r&An t �ra..t� <br /> i <br /> JE X A N, F LIE1 1112-131 42408-8 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />