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;. <br /> Waste Tire SL jey & Inspection , 11% t u EY REQUIRED <br /> State of California i - - <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection �7 <br /> Site Suffix: 1 `1 1 3 O Report I t — t 2 2 g / <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -I�.Q��1,T��C�G�:�t C. 0�.�2 �S �rf��c� ��n �.►o��,c�.Vl.�.�a.�r <br /> N. <br /> a <br /> k �5 6C-C, <br /> kIE a <br /> 42408 <br /> X£ A hh P ( a 1 2 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />