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Waste Tire S e & inspection Re <br /> sE Y p SURVEY REQUIRED <br /> Ei. • State of California <br /> —"' CIWMB183 (New 04104) C mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ! Z 8 `f (-2 119 5- Report <br /> Number:, <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> /` 44Zu r7 L171 S>"� / '•� - <br /> —3 - <br /> fLir-kA1 <br /> 4 opq off' tarn-r-4 - -7-PI LDC.tr�' <br /> _- _-- -- -E 42408 <br /> ?C � � IP L �' � 2 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />