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Waste Tire Sup ✓ey & Inspection Reps._ 4 SURV =REQUIRED EM <br /> F1. State of California <br /> kffi — CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- 3 7 O ` - Inspection <br /> Siteffi <br /> - <br /> Site Suffix: <br /> 1 ' Report I I 5 O <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 6�ti ram <br /> 2 r• �� � TS mow. l�•1�on �-`y U�et� <br /> skis %AA S 2 �t <br /> I X1 <br /> AM R I ' 1112-73 42408 <br /> ■ <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />