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._ <br /> Waste Tire S- --eV & Inspection Rep t LSURVEY REQUIRED] <br /> I.ili3S State of California <br /> CIWMB183 (New 04104) Comments Form -- <br /> Callfomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - M l - Inspection <br /> Site _ 1 a 3 a 9 <br /> `� ! <br /> Site Suffix: Report Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> - <br /> G� <br /> � <br /> CA,0Jo���k� Yom—-1'0 n � eTJ S � <br /> C 1QjtA S I fie. <br /> c Ad �LA'S) I <br /> LZ J cA,):,,, �,b Tlce C S 0, y4- j-,s kf <br /> ffc-)Xn <br /> �n 44e_ _ � - �-L Gly <br /> o e� P S a J �1y s Lti1 sS�f� <br /> 42408 <br /> e A A MP (r E111 ; ZJ31 F:01M a <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />