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AWaste Tire S vey & Inspection Rep j SURVEY REQUIRED <br /> kaO <br /> StatefCalifornia ■ <br /> 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: Re ort ^� <br /> 1 ® Number: I <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> L J�e , :Pry coA*cw c 064cAaind (Avc1lL,19 <br /> —Aoi <br /> CELS, �v ; �1 r�, -LL <br /> le t o Nt P i e i 3 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ® ■ <br />