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k <br /> :Waste Tire S*ey & Inspection Repot SURVEY REQUIRED <br /> State of Cal <br /> --,,—`- CIWMB1831f'New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- U Inspection <br /> Site Suffix: $ —1 y 1 Report I 1 — 1 Q <br /> Number: ` 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -C� <br /> �c _cwt <br /> 42408 <br /> le A ul Pei Ei 1112T31 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br /> � � <br />