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Waste Tire & re Inspection. Re t <br /> �/ p SURVEY REQUIRED <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 /> Site - ' u O O 1 I Inspection 1 2 I <br /> Site Suffix: _I 1 - Report = - <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 2,1 <br /> -(9\:11 oi,, � � <br /> 3), <br /> �SoGsCAA <br /> St <br /> SA -S <br /> JE A P E 1 a 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA Fd� <br />