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Wastea Tir ✓ey ` Inspection t <br />■State of Californi <br />CIWMB183 (New 04104) omments Form <br />California Integrated Waste Management Board <br />Business Profile Inspection Details <br />TPID - , t e Inspection T <br />SURVEY REQUIRED <br />BLUE OR BLACK INK PEN <br />�. n ^ T.— %-- n <br />Site Suffix: U U' v ` �epul mbi J- ,,1 .L .1 <br />Number: <br />Inspection Number on the associated Survey form (Page 1) <br />Comments <br />1,Sc s L G YLi n f� j r Cc-, y' S Var a. <br />41 for ccv,ltw- <br />Jw" 4�� <br />White Copy: CIWMB Yellow Copy: Operator Pink Copy: LEA <br />42408 <br />�■ <br />