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■ ':__ Waste Tire S& ey 8 Mspacflo Re[o( SURVEY REQUIREDState ■ <br /> Lim <br /> CIWM fCalif(New Comments Form <br /> CIWMB 183 (New 04/04) �� <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> �Q inspection � U <br /> TPID (� <br /> M 1 (� vI _ Report I �y 4 2- I Z 3 g <br /> Site Suffix: / Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �• CA-C, e Y'\\ <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />