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-Waste Tire Avey & Ins ection Re p � - A SURVEY REQUIRED <br /> -- -- <br /> ••°.'1• 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 Report "7 C+� 6 F <br /> Site Suffix: ` "� (� _ I — <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Y-e-- <br /> A- tr r, - <br /> 42408 <br /> le XIA MIP LJEJ 111 <br /> ;:M:my <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />