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■ Waste Tire 4&V & Inspection Rol SURVEY REQUIRED ■ <br /> StateofCalifornia <br /> CIWMB183 (Now 04/04) Comments Form <br /> CalifomlaIntegrated Waste ManagementBoard BLUE OR BLACK INK PEN <br /> Business Profile 4 1 O Inspection Details <br /> TPID- Inspection <br /> Site Suffix: � - Report "7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> HIM) . <br /> U-�NNA Iz�'A \ntr cok\ Ax,4� c-s to\ <br /> �r -V4 �c �J �1 1A VAA , (,)l A NCk7b(A I � <br /> U - i <br /> nP �os cum <br /> 1-a-- <br /> V�k\J N1 r <br /> L�� �ZL—( <br /> U,� , r <br /> E A MIPI 442408 <br /> - White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br /> ■ <br />