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Waste Tire ey Inspection Rei. t SURVEY REQUIRED <br /> ■rru Stateof 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 /> TPI ' - Inspection <br /> Site Suffix: (n <br /> O ® l Report <br /> Site Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> - <br /> .. <br /> t � , LA r <br /> d—s k <br /> J. <br /> �o rci <br /> N, r,,4, J— r LK e\ IA /A <br /> C) Cr <br /> 00 - ' <br /> JE XIA MJPJ �JEJ 111273 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />