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Waste Tire SOVey & Inspection Rept SURVEY REQUIRED <br /> ••'��• StateofCalifornia <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 2 c> 2 © ' Report <br /> Number: ` f <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> A� CA&C <br /> JE <br /> A P! e I 1112131 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />