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Waste Tire S y & Inspection Rep SURVEY REQUIRED <br /> y: ' <br /> State of California encs Form CIWMB 183 (New 04/04) Comments 11 1 1 <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection <br /> ect on <br /> Details <br /> _ p <br /> Site Suffix: — I _ <br /> ReportI <br /> ! t <br /> In <br /> �f <br /> TPID- Number. � { <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comment " <br /> _ f <br /> 1 <br /> r � <br /> F_ <br /> t � , <br /> 1 <br /> '+' ✓ { <br /> r <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />