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` 3 SURVEY REQUIRED ■ <br /> Waste Tire irvey & Inspection RE )rt <br /> ■ w8� <br /> State of y ornia <br /> CIWMB 831t(New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: L 3 3 O ' Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> !4- <br /> CP <br /> -- <br /> tipAc-s <br /> t <br /> enc rl 3�itor� <br /> i( S G <br /> 1112131 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />