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•--- <br /> '� :_- Waste Tire SL ey & Inspection Rep4k .SURVEY REQUIRED <br /> �..-- <br /> •_.=.• State 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 /> TPIInspection <br /> Site -Suffix: `` � �• l Report I ' <br /> Site 1 � 7 6 � � 1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 2. <br /> 42408 <br /> 11LIE1 111251 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />