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Waste Tire S�-_ ,/ey & Inspection Rep .t Q <br /> SURVEY RE UIRED <br /> .__. <br /> •••!..` State of California - <br /> .___ - _- <br /> CIWMB 183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- _ nspection <br /> Repot 'L I J _ ^ O J <br /> Site Suffix: <br /> Report ae. <br /> (dumber: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ------------ <br /> '1 <br /> l0 kk s f S cJ' WU�S7G 1�.r <br /> IA - <br /> eA C C'�)U e)'JCJ <br /> • �, ;��er- man) C,s s 1 LAS -- <br /> rLs z4 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />