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■ ":�. Waste Tire SL ,ey & Inspection Rep SURVEY REQUIRED ■ <br /> ■■■�� State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> TPID- / n Report <br /> Site Suffix: Number: 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ' — <br /> 2. <br /> ��f7 1, <br /> 42408 <br /> I-E-XjAm I P FOE 1 11112131 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />