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Wastes Tire ey & Inspection R� . �t SURVEY REQUIRE <br /> -__ --D <br /> State of Californi <br /> ■ J SURVEY ■ <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> ` Repo <br /> Site Suffix: 9 Number: — 1 0 6 5 �f/ <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> I t` 1-1 6n <br /> Ain VI"n 16,,47`7, -11N c- cz n f— e,��en--n s <br /> Oily <br /> CA �l' ' ® Ito S jjje Z /.3 <br /> ii^^�� ii y <br /> fae-ld <br /> -I L,e 4-IM L �J S <br /> PN <br /> P I E 1 j � 3 42408 <br /> A <br /> r ■ <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />