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:Waste Tire S�,. Bey & Inspection Rep,.t SURVEY REQUIRED) <br /> ■■•'+ State of California <br /> i- CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- - ® Inspection I - <br /> Site Suffix: S Report 1 1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> K IA X Jtal <br /> 1l,b� TvJ �(,�1 A) <br /> W-M S b +> rJ, a r�i�c.ST S lYlyl S I <br /> 42408 <br /> , -!nL <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />