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Waste Tire S. ►ey & Inspection Rep SURVEY REQUIRED <br /> 114.•,-�_�_t a a: 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 /> TPID- Inspection <br /> Site Suffix: cA GI e2,III, I _ 0 C> / <br /> U l ` Number: l� <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> o <br /> L UL � -61 <br /> 42408 <br /> ® �XAhhP LIE, <br /> White Copy:CIWMB Yellow Copy �_s•a.-)r Pink Copy:LEA ■ <br />