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Waste Tire S ey & Inspection Re rt SURVEY REQUIRED <br /> •'��• State of California <br /> CIWMB183 (New 04/04) mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> t <br /> Site Suffix: �- 4 5 D f3 l Report I I _ I l 7 -7 j 7 <br /> C7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> n �_�► `�'�_ C3�.,,,�_ c����tai�i�e � C'�v�ec�J <br /> ���c9.,�c�-S ��c' �t-�•� -�er_-e�-- �'e vin�.ra.�. o� l�a 5�� <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />