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_Waste Tire Vrey & Inspection Re jol SURVEY REQUIRED <br /> W•'i: 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- i Inspection <br /> Site Suffix: 1. C� (D I Report = I — 2, `j 3 5- f <br /> ` Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> tz!1-kocL an LLXLLC, insic:i's- <br /> Z) cp-AtLy,-6 4, 92.,- AN <br /> iri t�o ryu C1Z5 coma. <br /> A\ L-VL LL-e 5 /Yt-U— Ph) L,1--3 a.&49 ZL41V <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />