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Waste Tire & ,i'ey & Inspection Rer [ SURVEY REQUIRED <br /> •!!� State of California <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- i Inspection <br /> Site Suffix: 1 c) it Report <br /> Number: <br /> - Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -J-')�. <br /> gf a� <br /> if- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />