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Was,tea Tire SVey & Inspection Rep SURVEY REQUIRED <br /> State ofCIWMB 183 New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - - O 1 Inspection <br /> Site I 1 _ I <br /> Site Suffix: d Report 1 <br /> LA <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �U!C <br /> 2, kAA-QIYS:'-�Qr�� (.,t S <br /> vo <br /> l <br /> h� �a Ove S <br /> �r <br /> o <br /> V i <br /> I l`ec ov-5 <br /> _mac y10�5 ;k��w G-- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />