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XWasteifornia Tire SP jey & Inspection Re- SURVEY REQUIRED <br /> !�1! State of CalCIWMB183 (New 04104) ` jmments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- r Inspection <br /> Site Suffix: r 3 ;zG� �p - ( Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 42408 <br /> IEXIA h�4 PL �' 1 �- � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />