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■ ::A <br /> Waste Tire Sl 'ey & Inspection Rep SURVEY REQUIRED ■ <br /> •',• State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- 1 2 ` � _ © Inspection _ <br /> Site Suffix: 7 1 Report = o <br /> 7 � Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 1,t 12'71 a k­r�, lof 21 t4 cis.\\A V\ 4-- VVV1_, ,,t 6 <br /> - U.S GkAS0 n.\CA L�Q <br /> 01 <br /> .4150�1)- _All'cr.� �am 6-e- �e_PA oy\_�k_ <br /> LJ' A MI P i 111273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />