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103 2 38% <br /> ■ i o¢. <br /> Waste Tire Survey & Inspection. .Report : suRUE�r`REQUIRED <br /> Ii9 State of California _ <br /> • CIWMB183(New 04104) Comments: Form <br /> California Integrated Waste Management Board BLUE OR BLACK CNK PEN <br /> Business Profile Inspection Details <br /> TPID- c i r i I. I Inspection 1 <br /> Site Suffix: J i ' v`I 3 I O I I Report y I I <br /> I Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> L t 1 <br /> 0 wnt <br /> 1 t <br /> iGS 0_C1�S c a,f_Vj 4 Y k_T OjtcS_(- U net <br /> 42408 <br /> White Copy: IWVO <br /> Yellow.Copy:Operator Pink Copy:LEA <br />