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:Waste Tire S ey & Inspection Rep t SURVEY REQUIRED <br /> State CIWM ofCaliforniaComments 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- Q 2 u Inspection <br /> Site Suffix: 1 t� l 1 l Report 2 1 — r �7 y 2 <br /> Number: L <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -- iN <br /> k .� t� N\ <br /> ���5 ���� �� ��� �� �S <br /> !r Nt <br /> le <br /> A P i i a 3 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />