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Waste Tire Mvey & Inspection RIAW SURVEY REQUIRED <br />E.... State of California Comments Form <br />CIWMB 183 (New 04104) <br />California Integrated Waste Management Board BLUE OR BLACK INK PEN <br />Business Profile Inspection Details <br />TPID - Inspection <br />Site Suffix: 1 5 , Report I — 1 Ll <br />l V r7 5 <br />Number: v <br />Inspection Number on the associated Survey form (Page 1) <br />Comments <br />l��<21 <br />AD t 7 , S V L cY1Q. s� <br />11r(1 Y�_ /I�1ii�c ail <br />A LA- L,� _J� <br />khk <br />---- - - - - - - s Xl <br />N 3, -�, � 0 tPC,"—,P <br />JA MI 1112131 <br />White Copy: CIWMB Yellow Copy: Operator Pink Copy: LEA <br />42408 <br />0 <br />