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Waste Tire S&ey & Inspection Rer- t SURVEY REQUIRED <br /> ■ k: ---::i_C■ State of California ■ <br /> 'New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Q-Isiness Profile Inspection Details - <br /> ID_ 1 Ins ection / <br /> Site Suffix: Y 2 7 � 3 d Report I — , G (_ 6 S <br /> Number: v <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> G�be��0. <br /> '76CXA\4 <br /> AM <br /> UD c�S ane- - c _ CSV V\V,\ � Sle XIA MIPILIel 111273 . <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />