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:::==: <br />- Waste Tire S vey & Inspection REQUIRED <br />. nspecon I�1:S-U—.-� <br />State of California <br />CIWMB183 (New 04104) Comments Form <br />Califomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br />Business Profile Inspection Details <br />Site - / �J _ Inspection 1 _ ^ <br />Site Suffix: o `� Report �j <br />Number: I ee <br />Inspection Number on the associated Survey form (Page 1) <br />Comments <br />-e� <br />Ar� f7. l X12 c��.-1 <br />r�'1n <br />e?AMiP LE <br />White Copy: CIWMB Yellow Copy: Operator Pink Copy: LEA <br />