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- - -------- - - ------------- -. <br /> ' : Waste Tire S�._ ./ey & Inspection Rep. SURVEY REQUIRE ■ <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 Details _ <br /> TPID- <br /> r, s Inspection _ I <br /> � V Report = -/�I■ <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments -- -- <br /> �PeAe k Scs <br /> kijo, d SJ <br /> ®� olo- <br /> U Ill I j LJ S c.y 1 c W . <br /> I �� 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />