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Waste Tireey & inspection Rer 't SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New 04/04) mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: Z - Report <br /> , Number: la J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> lVoks <br /> Xr., Gvecrlc- <br /> c!%sra SddcJQ <br /> icy- <br /> -3�-)-. -TP D A cG,.t� [-t j2lc --rcj . <br /> 42408 <br /> e XA1V4PLEf � 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA P-47 <br />