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Ins- Waste Tire S w _S/ 8t Inspection Rep SURVEY REQUIRED <br /> -- <br /> State of California Comments Form <br /> CIWr+1B 183 (New 04104) <br /> California Integrated Waste Management Board BLU E OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> Inspection <br /> TPID- 1 l ` Report <br /> Site Suffix: l Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments _ <br /> 1 � i <br /> a, <br /> - <br /> b` <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />