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■ Waste Tire Survey & Inspection Rej. it SURVEYREQUIRED- <br /> i:�"aS <br /> State of California – — <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> I _ I Inspection <br /> TPID- Report I <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ' �o lRcti <br /> o 011poo ct n o1A M I C,6, ae- Aj LtD <br /> 1 <br /> 11 1 ( I lI t <br /> Sf�J�1��J <br /> U <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator ■ <br /> Pink Copy:LEA <br />