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===- Waste Tire ;ey & Inspection Rep t SURVEY REQUIRED <br /> '�'• • State of California <br /> CIWMB183 (New 04104) Comments Form - - <br /> Califomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - <br /> Site Inspection <br /> Site Suffix: "1 j� O � Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -- cs�,x�`^b�����-�.���—�►'�r `cess ve�� c� �a,��,`cs�� <br /> � ♦. ♦ ��(��(��C'i�T SLS � ����P` ��t��T— <br /> �.� <br /> T= 1- 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />