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Waste Tire ey & Inspection Rep, t SURVEY REQUIRED <br /> ••"�• State of California <br /> -- 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 /> TPID- / Inspection <br /> Site Suffix: ` 'Z " C> ` Report I 1 — 2 y °Z l 6 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> \zc teN:ova• -- -- - -- <br /> - p <br /> JE XIAMIPILIEI Ill <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LFA COT <br />