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Waste Tire & ✓ey & Inspection Rep t SURVEY REQUIRED <br /> •"'" State of California <br /> ----- Comments Form <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- ins�� _ 0 Report <br /> tion I / (n <br /> Site Suffix: ` ` Number: I.- c� I _C_ q 3 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> L � 1 <br /> G -TV�Eb hof e <br /> J <br /> --Zkvl <zl. <br /> lip <br /> �. *0u-S <br /> c (lC'J Cv <br /> I <br /> ,A� �G <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />