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Waste Tireey & Inspection Rept SURVEY REQUIRED <br /> ���7►_ State of California L <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - LA �„ l Inspection <br /> Site _ <br /> Site Suffix: v Report t7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> FLA ' Ut✓S�� LASS wiu - Drj <br /> 10j\ - <br /> c.caL LJV1A SV <br /> '11aLu iur 1, <br /> e- w-, lAafc.) -U\.\j ell <br /> 6A <br /> 42408 <br /> JE XIA MIPILIE1 11 273 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />