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Waste Tire S ey & Inspection Repot LSURV <br /> EY REQUIRED <br /> DL;;ai <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 t, <br /> Site Suffix: O ` Report I ` — 1 7 7 - _I 1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> W'z oh SAC- 0,Y-4, owoa IgVe <br /> 2) A CTLSeac'cL. c am- �� c� �, -keorh <br /> /' 112 013 t'�S � t _ V- <br /> " 'I etn�ct`i h t r %A& S � E �468' 392, <br /> C Lin, <br /> (-2 <br /> 42408 <br /> t � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />