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'■ .�„ Waste Tire Survey & Inspection Repu."t os SURVEYREQUIRED <br /> ,-'37SSi StateofCalifomia Comments Form <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection -1- <br /> --Fs <br /> TPID Report <br /> Site Suffix: I �� � Number: - �- —� L_- -1�%' � <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �—�aris�SS Vie.,—C�V_ce11c�, 45—f_e��ejA0T <br /> w&m.on <br /> Elx AIMP L EI 11121:3 42408 <br /> White Copy.CIWMB Yellow Copy.Operator Pink Copy.LEA <br />