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IlWaste Tire Sftey & Inspection Re SURVEY REQUIRED <br /> ••OJ�: State of California <br /> CIWMB 183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- C _ Inspection _ S <br /> Site Suffix: J /llJ IL Report Number: = Q- (' <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Ll51 n 1 `J S C�114()k Ali j C S CK -j `"Q I�r <br /> Vim. Z"V r4 <br /> Lk• IQs A c.-AR <br /> S _ tlt)Jl �O Tu C'X i , ,Al 'r, Its V,/L Aarcj <br /> -WX I 0�f QJE XIA MIPILIE1 111273 n <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />