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Waste Tire St re & Inspection Re t <br /> LOW <br /> - Y � pSURVEY RE_! 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 /> Site - ` 1 _ Inspection _ <br /> Site Suffix: � `-� O Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> kz c&\-I;c q>,,c s 6A- �X P- <br /> C <br /> • � din � � �S� ''�,�5 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />