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WasteTire Survey & Inspection Report <br /> ort Re <br /> ' ■' � . . = SURYEY; REQUIRED <br /> °i State of (New Comments Form <br /> ornia <br /> CIWMB ttil�(New 04/041 .. <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN . <br /> Business Profile Inspection Details <br /> l Inspection <br /> Ste Suffix: I I C�. a•; 1 i O ! _ i Report <br /> Number. I i I / I U .� <br /> Inspection Number on the associated Survey form(Page 1J <br /> Comments <br /> �(Jks a�� _� � �n;� _ <br /> c --c 0t sx a� f b to �I1�,se <br /> tA <br /> 42408 <br /> ■ EXAMPjL. E' 1 ;23 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy.LEA <br />