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_ Waste Tire S vey & Inspection Rer A SURVEY REQUIRED <br /> •:_��•! State of California <br /> CIWMB 183 (New 04/04) <br /> 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 Report I 1 1 2 5 5 8 Z <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> V e- <br /> y alp r <br /> d <br /> 42408 <br /> Anh P: L Z 3 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />