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Waste Tire S- vey & Inspection Rer- 't SURVEY REQUIRED) <br /> k• ` State of California <br /> u CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- �] Q Inspection <br /> 3 / C.� �. Report <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> b,.-A ,rr�-, c� a-,f, --�1n ►3 c��-a,fir <br /> c,� �2 iarl - <br /> �3 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy.Operator Pink Copy:LEA <br />