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Waste Tire SL /ey & inspection Rep t � SURVEY REQUIREL i D] <br /> !:U! State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> Califomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - 3 9 <br /> TPID- Inspection <br /> ` > -30 Report 2 , — , 2 <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> V Q�. <br /> \\ Z Q <br /> 29k <br /> � 42408 <br /> A M P 1 2131 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA LIPT <br />