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Wastes Tire y & Inspection Re SURVEY REQUIRED <br /> 1!!11! St te of Californi <br /> ■ -- ■ <br /> CIWM6181 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ' S 2 9 8 Q Report I — 2 7 -F <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> — t- i�-111.6/CZHUY1 S enr (L/12aiSQ�l�orn�ii,-Annt <br /> s ' <br /> Cac_C: L; ZL Sc c I' L c Ccr - >z —)�r wcc.t)t� 41 rt- <br /> pt i t Ire o s CLO . -- --- - - <br /> VtOr <br /> G'—T_ - - — <br /> !Pl D <br /> E X A hti PSL E 2 3 42408 1 � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />