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Waste Tire S ey & Inspection ReK SURVEY REQUIRED <br /> Lellsy <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 /> / Inspection <br /> TPID- _ <br /> Site Suffix: (s �j C.f Q ! Report j <br /> Number: 6 5 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _��11{r'C7 •�M.-f' U�' �f'T�-r' U 't'_- C.'G73�Crr.�'1�-+ <br /> - <br /> 1� >s��,� <br /> r <br /> :2 <br /> — Gini f/�U fCr.,rZ ,��-.r:'r����..�,c/ �e�s�r r� ���' �►-�' <br /> t r - <br /> 42408 <br /> fYl f' 1 . <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />