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: Waste Tire Sd&ey & Inspection Rept <br /> SURVEY REQUIRED l <br /> �3�5°' State of California I_ <br /> CIWMB183 (New 04/04) <br /> Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - 1 - 1 Inspection <br /> Site 1 _ 1 <br /> Site Suffix: � � Report I e <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> IN I <br /> 1209-1461 3c12• <br /> Z) X)o ,s -Vk� �\ <br /> G, <br /> _S �� n r ` 113 Y\ �Nzlrcs , <br /> V St <br /> c rear S. <br /> 5.) <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />