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Waste Tire V & Inspection Re rt <br /> SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New04/04) om ents Form <br /> California IntegratedL2 Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - 1 i - Inspection <br /> Site _ <br /> Site Suffix: I Report 2 7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 14 1 0 &OLO%n r erve'c,e.. <br /> IQ— +o r� MSulv <br /> on wtft-- <br /> A 1 42408 <br /> i <br /> White Cop :CI Yellow Copy:Operator Pink Copy:LEA <br />