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:LJXV <br /> ;Waste Tire SMorymyemyents <br /> & Inspection Iyer -t SURVEY REQUIRED <br /> + CIWMState fCalif(New Form <br /> I!—,! CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> Site Suffix: i f � `-{ I� - � i Report <br /> p rt � - <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> � d 011,d I,U Ci ,Ir Wkt le II o ) , (, / ..ri_, i a, r6} 1(e 1� &j, <br /> f r)61"'v10 o 1(; r e t r .' ,; at -04 i? t FT`✓ <br /> fi <br /> Yr t�\,LA✓r vYti it J - <br /> �.J <br /> �(IL -i� �• - �tr (� � � ' 'I � VUGI XcL,1AC <br /> r <br /> fA'k CA P/ r ��ln <br /> A0 <br /> JE <br /> 7A <br /> 42408 <br /> Pil� EI 1123 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA F:M:mh <br />