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Waste Tire S. ey & Inspection Re 1 t 9 SURVEY REQUIRED <br /> • g,. State of California <br /> CIWM8183 (New04/04) C,j mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - /�nn Inspection F—II41 — lib- <br /> 1Site Suffix: 3161 3 V ' Report 2Number: J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ���U � <br /> NA I L P 1025 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA P-T <br />