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Waste Tire vey & Inspection Re*t SURVEY REQUIRED ' ■ <br /> •••'y. St ate of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- inspection <br /> Site Suffix: 3 a (j Report I _ r 1 6 -7- 0 2 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Cir —,'e r for— <br /> IF <br /> or— <br /> —�o/tr — <br /> — <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA F41 <br />