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•IWaste Tire & ✓ey & inspection Rer 't SURVEY REQUIRED <br /> State of California ---- <br /> CIWMB183 (New 04/04) Comments Form <br /> Califomla Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> l _ O Inspection t _ <br /> TPID- X11 Report <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ( � FA-L\ - <br /> t s �� <br /> V1111VI <br /> 01, <br /> 1 <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />