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s _ SURVEY REQUIRED <br /> Waste Tire S#ey & Inspection Rep <br /> ■■'•• State of California <br /> CIWMB183 <br /> New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- d ' Inspection _ 1 <br /> Site Suffix: Z 3 y Report I 2 1 � Z <br /> 1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 0�i k-t <br /> << �A, <br /> ` e-� <br /> 1&u, <br /> � �M-ca T <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />