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Waste Tire Bey & Inspection RE, C SURVEY REQUIRED <br /> State of California <br /> CIWMB 183 (New 04104) <br /> Comments Form �_ _-_-. <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 1 — G Report I _ <br /> Number: l O <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> jE � :2408 <br /> jEjXjAjMjPjLj III ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />