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:Waste Tire SGrey & Inspection Rei. t SURVEY REQUIRE <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 /> TPID- u Inspection �} <br /> Site Suffix: l Report I :LNumber: O'� <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> tib`ct. �vt S 4vxces OL <br /> N©k's 0 <br /> -i '✓r-- cm s Z lZ CL vG. 4 l pi- <br /> ak V1 C vq vz��- i2' r •f— ah�� R.V���c� �� <br /> ✓�'vt7tC,�� `f•O✓ '� yl'Lr�✓L r l?2 t�i��t p� � y 7'�(f�, <br /> 42408 <br /> JE AMPILEI 111273 - I <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />