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_ 030490SO027 <br /> Waste Tire Survey & Inspection Report SURVEY REQUIRED <br /> State of 183Comments Form <br /> CIWMB 187(Na"(New 04104) <br /> Catiromla Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> O O Inspection <br /> Site - Report m / 1 ,33 <br /> Site Suffix: (`n R"'� Number: v <br /> 1.6 Is <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> UV I l f� bh �L— a� 21wr�-2t'e <br /> nc�a '.ona1 yencCor- -tire se� ✓T cclohe. on _' -e. b�y�� <br /> yiola*f4ns ✓low. <br /> � /Dg , <br /> Y <br /> :t. <br /> c• <br /> 42408 <br /> EIX AINt P E 1 2 3 <br /> ■' White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA © ■ <br />