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WasteTire urvey & Inspection Dort <br /> State s LuRVEY REQuiRED <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile -I_Inspection Details <br /> Inspection <br /> TPID- r �� Report 0 <br /> Site Suffix: z Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 4.) Lt <br /> ��� 42408 <br /> E" � fYI � L � 1 . � � -� <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />