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• ..�s� <br /> Waste Tire Survey & Inspection Report <br /> State (No. Comments Form <br /> CIWMB 783(New OMD4) <br /> California lntegratad Waste Management Board BLUE OR BLACK INK PEN <br /> BtleinmProf le li Inspection Details <br /> TPID- Inspection ) <br /> Site Suffix: // 'J Report <br /> U / / � � © � Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> L �k7�t�crz�, /o-t U�o��jG�-fe�- t`"L• l I`C 4zcIn S� �r, <br /> h2 �e.0 i L�y S -kp LAS&- Ck <br /> 4 6,1 <br /> w� (''� -�'f►�5� ��� niers a-� --{��- ��,1�a� <br /> r,4 LA 1'1–�j l S taw aj tr \v'�. 1`e!! `l—"`r_r� • . <br /> G <br /> i►. ,v a E;w. C,I-C, — Innate 1 el rd!nis *Ack— cWj <br /> 10XIAIMI P I L I E1 I I I Z I3I 42408 <br /> i ■ <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br /> 0526306.0338 <br />