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' >< a Surveyand Inspection Rep(,. ,,� City/county <br /> Waste <br /> P P Mailing Address <br /> i 00° Phone Number <br /> tate of Califomia <br /> :IWMB-54(10/03) <br /> 'ART D -Notes Page --of 2— <br /> File Number: Inspecti D e: <br /> V tb d <br /> Bu in ss/FacilitxName: GPS oord' ates: <br /> SAW �. <br /> 01A S�S <br /> ` •f7 V I a \w�lskA R_�� Q a� � ��i <br /> Follow-up: <br /> ❑ Letter of Violation ❑ Violation re-inspection ❑ Refer to CIWMB Date: <br /> Date Mailed: Date: <br /> ❑ Other Referrals <br /> ❑ If this box checked NFA required. ❑ No tires, remove. ❑ Out of business, remove. <br /> Inspector's Signatun Phony <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />