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Waste Tire SL ;ey & Inspection Rep SURVEY REQUIRED <br /> i__u• State of California i -------- _---- <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- <br /> Inspection -7 <br /> ��11 <br /> ! - p I - -7 -7 <br /> [ V <br /> Site Suffix: 1 �. Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> A] 02Y A)C? c� j -L:�;rt Ile <br /> & <br /> IF <br /> 3 b 3 yu) < -III- <br /> 1 <br /> on <br /> ►'�. '1� _ �� rvlctt�L �. <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />