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Waste Tire S0jey & inspection Rept SURVEY REQUIRED <br /> ••''u' State of California � <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> q- (J ` _ Inspection <br /> Site S _ ' <br /> Site Suffix: O i Report Z .5 Z <br /> I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ����ZV �-r"�L�,�-cCc�:� (,.� CXR T��'� V,,l1,CQ-�"I[)Y►�.`�-1- <br /> 14 L <br /> 7ha,e , i�, hal nG u-)u ofQ t6j5 aJ- 4lc,e. <br /> 1 Ocu�� <br /> IE XIA MIPI LIEI I t 12131 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ;-!!A <br />