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Waste Tire Sr ✓ey & Inspection Rer 't SURVEY REQUIRED <br />•��� State of California-- —. <br />CIWM6183 (New 04104) Comments Form <br />California Integrated Waste Management Board BLUE OR BLACK INK PEN <br />Business Profile Inspection Details <br />TPID - ✓7 inspection <br />Site Suffix: 1 $ ® © Report 1 2 Z 2 <br />Number: 1 v <br />Inspection Number on the associated Survey form (Page 1) <br />Comments <br />c>< ya ce C <br />Sn\-Qs 6e< xvs, Se�neS'�i <br />TAM, -IN-is L 5 ins � <br />act: ►S \oc�.� �cwl - - <br />1E XIA MIPiLlel 11 Z73 <br />White Copy: CIWMB Yellow Copy: Operator Pink Copy: LEA <br />42408 <br />