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_ Waste Tire S` iey & Inspection Rep t SURVEY REQUIRED] <br /> ■r•SL• 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 /> Repinsort <br /> I _ 5 9 2 <br /> Site - ` -7 —7 5 Q G _ D ` Nu ort <br /> Site Suffix: G. / v I �/ Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -2) e"cV N x>x,e <br /> W�ciz�,�I;4� l�Gam- ��� ��•r,r� ��c'.�, $ �� <br /> � tsc2 vo.Y�� s,�Syv.�s� ysa� Q�s� <br /> 42408 <br /> JE XIAMIPMEi 11 21-�- <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />