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Waste Tire Swey & Inspection ReK t SURVEY REQUIRED <br /> State California Comments Form <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> t <br /> TPID- Q I Inspection <br /> Site Suffix: <br /> � '"1 � � � _L / _ Report I O <br /> p Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 5 dos - <br /> Alt <br /> 42408 <br /> JE XIA MIPiLIE1 11 a131i <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />