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Waste Tire ElEOey & Inspection Re SURVEY REQUIRED <br /> •"d1• State of California <br /> Imo: CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board __BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 1 0 '30 <br /> l Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> (k <br /> Qj UOS )&)'(,(DIA <br /> on <br /> 71 Ll LLQ 0 .oLAn L iz cn zA <br /> -7 - 01 <br /> -C . U1�1 <br /> ;��� hit P � � _ 1 � � 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />