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Waste Tire S_ _ Bey & Inspection Rer, t SURVEY REQUIRED <br /> Lk State California Comments Form <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile inspection Details <br /> Inspection <br /> TPID- —1 _ Report <br /> Site Suffix: Number: v <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> aq- <br /> _..�t�'l,�—�1"✓��_ [ti�'lr?� '� �'J �/l T Jnr� <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator ■ <br /> Pink Copy:LEA <br />