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kRWaste Tire Sy & Inspection Rep SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection DetailsAN <br /> - <br /> Inspection ([ <br /> Site - l - - <br /> Site Suffix: e Report I ��' — f I �.1, ! i <br /> Number: 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> rC W, T <br /> < <br /> I� 1 <br /> �424�08 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />