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Waste Tire 90vey & Inspection Re j*tSURVEY REQUIRED <br /> ■ a. �._�� State of California �.:------- ----- -- <br /> CIWMB783 <br /> New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- <br /> Inspection �-r /�) <br /> Report = _ .1— .L_ /, <br /> Site Suffix: 3 d Number: 6, (J( t <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ay <br /> AIA it—cr- <br /> c�-��-�i�v►_ �-� � �—'fit � � - �� <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />