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........ --- --- - <br /> .... . <br /> rey & Inspection Re, t SURVEY REQUIRED <br /> Waste Tire �� _ _ _____ <br /> •::'�• State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection — w <br /> TPID- Report 2 '1 <br /> Site Suffix: C Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> aJL <br /> #, <br /> VQ <br /> S <br /> DS <br /> 42408 <br /> ? AMP LE � <br /> T 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />