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Waste Tire SL__ ✓ey & Inspection Replet I 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 /> Site - q s Inspection <br /> Site Suffix: Report I <br /> Number: O <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 3 Qn ry-) n <br /> r r <br /> 42408 <br /> � � r� r+�IPL � 1 2 � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />