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:::. - -- --- -- - <br /> LZI <br /> .Waste Tire Spey & Inspection Rep& SURVEY REQUIREDJ'•• State of California <br /> CIWM13183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - ` '7 ' t y _ Inspection <br /> Site L— — ` <br /> Site Suffix: 1 "` Report C <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Ssk ?2 <br /> AmPI EI 1 ' 2 � �42408l <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />