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*;A,, Waste Tire S*�y & Inspection Rep sUIwEY REQUIRED ! <br /> ••°!L• State of California I <br /> miry CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: r� Report t <br /> 6 ® I Number: ' ` <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> C es IS P_Cisk <br /> •� `� ® Ol - <br /> I'4e Ge iy Gi <br /> eS <br /> JE XjA_ <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA [NaT <br />