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LIM <br /> Waste Tire S jey & Inspection ReK t SURVEY REQUIREDSt ate of California <br /> m - - - - - - <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> TPI - <br /> Site _ S D <br /> Site Suffix: / rt I } <br /> 1 � � - \ 0 � � � 1 RepoNumber. �' d l <br /> Inspection Numb)on the associated Survey form(Page 1) <br /> Comments - - --- - - - <br /> Tc c,,; cLv`c-� - vh tx� 'fly at <br /> 1��� Lct�•t,� Z3 L��.�,� tit^- j `VuS <br /> VVA��{L" 5T P ✓L'� l <br /> G <br /> 11 ( ter � <br /> \Jj \--U - WU-�l <br /> 42408 <br /> ■ <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />