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■ ::._ ■ <br /> �=-- Waste Tire S vey & Inspection Rei. A SURVEY REQUIRED , <br /> lAat <br /> rrrrr <br /> State of California ------------ --_-_-- <br /> CIWMB183 (NewO4/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> _ � � E f <br /> TPID- ( ,r y Report I — ` `� <br /> Site Suffix: r.t � � � �—�' t0 l Numbe <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -bA <br /> j >-0 <br /> p � <br /> ■ 42408 <br /> FE-XLANP�L ��T � 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />