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":' SURVEY REQUIRED] <br /> Waste Tire S ey & Inspection Re t <br /> •••"• State of California <br /> CIWM- -3 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ' b 5 / - d , Report 3 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 5'D Poo <br /> �c2 <br /> 1re0-f • <br /> ZZ <br /> JE A MJPJJEJ 111273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />