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Waste Tire ey & Inspection Rer - `.t SURVEY REQUIRED <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 /> TPID- Inspection <br /> Site Suffix: e Report I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> i <br /> 42408 <br /> ■ E X A � P (r E111273 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />