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Waste Tire S trey & inspection Rer t I SURVEY REQUIRED <br /> :;j <br /> L't• 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 /> - ' 5 7 7 V p � o Inspection <br /> Site — <br /> Site Suffix: �j Report 2 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 10\,�c�'• ���t-_7e.cv:ce.., �-r__�v.��ce_ o-vo=����t� �pc <br /> FE—X]A Y P' 1 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />