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os a <br /> Waste Tire dkey & Inspection ReptI SURVEY REQUIRED <br /> •e'2t' State of California <br /> CIWMB183 (Now 04/04) Comments Form <br /> California Integrated Waste ManagementBoard BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - _�I /% Inspection <br /> TPID ^1 <br /> Site Suffix: Report I �/ �J� Q 1411Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> be- e 0E <br /> ■ IXRIMP LE 1 23 42408 <br /> White Co .CI Yellow Copy.Operator Pink Copy.LEA <br />