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'r --^Waste Tire 'F Vey & Inspection Re` -t SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New 04/04) _4mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: / Y J / - (� Report I _ ` oJ 0 <br /> Number: T <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> pf SGS <br /> _ <br /> 77-PS S 46ca .etsCf.P..z— a�Jn�✓ lflf/ �L[�/lsG¢ 40JE XIA MIPILIE1 111Z n3 (J��►t.✓ _ - <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA LO-47 <br />