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:;Waste Tire S. vey & Inspection Rei 't SURVEY REQUIRED <br /> ■••��! <br /> Sta te of California <br /> CIWM8183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> ck <br /> Site Suffix: Report b <br /> Number: J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> • l,uv l�Ca�rte— -11�,��� ���' V3�0 <br /> 1 f 7 <br /> Of <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ■ <br />