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Waste Tire ey & Inspection Rer t SURVEY REQUIRED <br /> State of California <br /> CIWMB183 (New 04104) Cumments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- Inspection _ <br /> Site Suffix: r S 4' `} 44 (� 1 Report I I _ � � � / 5 O f <br /> Number: (c� <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Szll. Arc <br /> �•yy��lo 0& y'mw e-r <br /> !*- A M P M E1 111273 424 <br /> 08 1 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA kia <br />