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Waste Tire Svey & Inspection Re�rt SURVEY REQUIRED <br /> "■■■_a..C■ State 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 /> Inspection <br /> TPID ' �{ �� e Report <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> j p c, OV <br /> 1�, Q0 Z -Yti ' t7 -.t�L� 7_1_� r� 6-- U-o�� -N U <br /> 1 a a f ' wr�.`. sZ c,o <br /> Ina, <br /> i <br /> i <br /> �� 42408 <br /> e 7a A d'�t P', � E y 1 I �I'.' <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ■ <br />