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_ Wastes Tire S ey & Inspection RepSURVEY REQUIRED <br /> !!-1! State of Californi <br /> CIWM8183 (New 04104) mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: [ 3 7 3 5 Report I r' _ t � � � J � 7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> . tLePer <br /> ky1 2 r,04 44—v-1 rL -90::j(egie aw'e�, 2r sA <br /> 06 0 0 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />