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Waste Tire Survey & Inspection ReportSURVEY REQUIRED <br /> ••• Stateof California <br /> CIWMB183 (New04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN rt <br /> Business Profile Inspection Details <br /> TPID- I Inspection �.� <br /> Number: I I� Lq <br /> 2Site Suffix: QV Report iI 1i-iL,- 66 1 <br /> LL--LL.. <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Y\ n _ S dere wyy-e- <br /> Qc..�1rx� V-xj v_nC' ner- a- ArSAn � I <br /> Q v � _ I na�n _per <br /> rr <br /> to- <br /> Man NJAJ_--C-01ren4ici� i o ra-4i <br /> v i e rs CU <br /> EIIXIAIIMIPILIEI 12 3 42408 <br /> ■ White opy: VBBYellow Copy:Operator Pink Copy:LEA ■ <br />