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; <br /> , Waste Tire SL ey & Inspection Rep` I SURVEY REQUIRED <br /> R----- <br /> ■■•'•• State of California - ----� <br /> CIWMB 183 (New 04104) <br /> Comments Form - - <br /> - <br /> CaiifornialntegratedWasteManagementBoard BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- b _ Inspection — <br /> Site Suffix: 1 � O Report I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 1.Aw,���� �• '�c�G`��-1 O�C�oCW�S ��'CQ. �2Cv���2. a,n�.o<�, f�,�v�cL2.s <br /> ova. �cvc\..S ■ '�c�-c,�e�� S2\S v�e_W �a �5�- <br /> c <br /> �•• �Q`�� C���` �Ccs �s �?�S�- �c�n �4•��CJ�� <br /> C�� .c . <br /> �Se_S M.c�ce`5 �zre. '�cP C �n�- n �\•yeSy <br /> �t S� �ctcr�•����koce.5 ��''S v�c�-sem�cc.S o� <br /> C>`!\ <br /> le <br /> XIA MIP L 42408 <br /> t 2 3 r <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />