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' M Waste Tire Saey & Inspection Rei t 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 /> ,ID- / Inspection = ` _ <br /> Site Suffix: 1 V Z 7 l 1 Report 1 6 q I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> CC %off i <br /> _ c _ G <br /> C �C�� c V���__ C�-��!J <br /> CK <br /> 01 <br /> cry <br /> " <br /> 42408 <br /> Ea � hh P � !: lid 3 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />