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Waste Tire S ey & Inspection Rei t SURVEY REQUIRED <br /> ••• • State of California Comments Form <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - 0- ` Inspection _ I 7 r+ <br /> Site Suffix: _1 L 1 Report I J\ <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> - <br /> `t• fie. wi '� <br /> 3, 4s:���-s. - <br /> 0Atav - - - <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />