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Waste Tire Avey & Inspection Rei r't LSURVEY REQUIRED <br /> ki!!!'! State of California <br /> CIWM- -- (New 04/04) Comments Form <br /> California Integrated Waste Management Board _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - ` _ o Inspection _ <br /> Site Suffix: 1 (,� Report I 3 D <br /> L Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> (d<,e.S s C L cif c,1'c kn enrjo- <br /> Al _ <br /> UNJ Ai nnw4, ,4-t <br /> t (A <br /> e—vdcn<,—!?Jl 5�}e� p�to s I) - <br /> i u l[ <br /> n� <br /> n &Vw' �UI �cVi ew <br /> f c, vt 'c ►' <br /> rlActi <br /> 42408 <br /> e XA MPI �JEJ 111273 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />