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® Waste Tirervey & Inspection Reirt suRveY REQUIRED l <br /> State of California <br /> CIWMB183 (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: 5 ' 3-1 Z ° Report <br /> Number: •- <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments _I <br /> Y� 'CCtLuv - C?r ; ---alrT ri-_, <br /> Q I <br /> q�CAC)i_T <br /> 1 <br /> - 7- Cj <br /> I <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />