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:Waste Tire SL .,,ey & Inspection Repl, SURVEY REQUIRED <br /> k••'-,: State of California <br /> CIWMB183--- 'New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection� � � _ � Inspection _ <br /> Site Suffix: ( `"( ` Report I 1 4 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> c0( <br /> l • .�' `Z.v � � � O� L cam.-�-5,�.- C.��� wrx�s� <br /> `VllLIJ 7 <br /> 5 KY0 WTM-5 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ' <br />