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Waste Tire Orvey & Inspection ReL rt SURVEY REQUIRED <br /> ••'�•• StateofCalifornia <br /> CIWMB183 (New 04104) Comments Form <br /> CalifomiaIntegrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - 3 "7 2 - d Inspection _ <br /> Report I c <br /> Site Suffix: �l <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> CCA 1\ 1 b 1 1� L.4 G(�I 1 11'1 I Agl <br /> C)4�1 C.Q,S Cil,(�cn.- <br /> vur�s c� <br /> -- 3 U.J fns LLQ. <br /> 4 4�ilC <br /> c-)�-{� 4 _fin u <br /> J� <br /> r J <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />