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Waste Tire SU 'i & Inspection Rep SURVEY REQUIRED <br /> State83al California I Comments Form <br /> CIWMB 1 New 04/04 <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> _ IReportnspection -7Ste <br /> SID ite y h I Number: I _ <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> r <br /> Al <br /> s Ll--,> fel <br /> t 4 � 6 <br /> old 9 mon4f Ls . <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />