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':_;._.Waste Tire SL- ey & Inspection Rep SURVEY REQUIRED <br /> �••'•' State of California - -- J <br /> • GIWMB183 (New 04104) Comments Form - - <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspec_ Report 1tion I k _ A z z cj 1 2 <br /> Site Suffix: � � � Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �IL� <br /> 42408 <br /> f; XIAMIPILIEIf <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />