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_Waste fire Sey. & Inspection. Rep SURVEY REQUIRED <br /> State of California <br /> CIWM6183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK (NK PEN. <br /> Business Profile Inspection Details <br /> TPID- J Inspection <br /> Site Suffix: r y f fJ / Report % 1lY,, 1 <br /> Number: �! ° G <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> L! 0"1 Gl V(t{~ 1 rt � ' ' l�[ J - G{ Y(% ' ! ( JLC r r D t'?' l <br /> I r,`-' I/' ne -l- < yed in (Ko <br /> ii <br /> f� 1f toId._f 101 l^l00t 14( or�LG.( ✓ ' <br /> V <br /> R�Orlod l Oco l firs or k <br /> 42408 <br /> 0 X A' L 3 <br /> 1 White Copy:CIWMB Yellow COPY: Pink Copy:LEA ■ <br />