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■ 'j:;AlWaste Tire Survey & Inspection Repurt SURVEY REQUIREUI ■ <br /> . :�.. <br /> State of California -- <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> ,c� -� w /� Inspection <br /> TPID- _ -^� / <br /> � u v Report = I �/�L, D- ..L., <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> s . <br /> �ttkl; otin <br /> EA, AIA 6,V( <br /> r <br /> t)I (C) CSW 4 - - <br /> u +) <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />