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Waste Tire S Vey & Inspection Rer SURVEY REQUIRED <br /> L2State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: j 1 l'' 1 Report = — /1 C2 /, r12 <br /> Number: �G <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ir- pie <br /> IL <br /> �Y n �1•. �C� �� ��Y. MC��i'_� l Com✓] <br /> 42408 <br /> EXRkIPI- EP � 3 i <br /> ■ White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />