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::;Waste Tire St rey & Inspection Rep t SURVEY REQUIRED <br /> •"*: State of California <br /> CIWMB183 New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INKPEN_ <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Report — ' I <br /> � <br /> q b t <br /> Site Suffix: 1 Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 01 <br /> -rte <br /> 42408 <br /> JE A MJPJSJEJ 111251 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />