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Waste Tirea Inspection Re t <br /> Y p p SURVEY REQUIRED <br /> • •��'�•�! State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> InspectionTPI <br /> Site <br /> Site _ <br /> - C� (� Report I ' Z -z 1 <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> VL <br /> 1L V N <br /> — �,�S�oS�� '��2..C-2�cP�'S 0..r o r-�r- � �' • �l'�n�S . <br /> 42408 <br /> IEXIAMIPILIEI T 2 3 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />