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Waste Tire r-•-ve & Inspection Re,- ~t <br /> •��aK <br /> Y p sU, uY� cp�Rr"n <br /> �)r8 State of California t��' <br /> CIWMB183 (New 04/04) Lumments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: r ( ! Report <br /> l Number. <br /> Inspection Number on the associated Survey form(Page 1) <br /> — ------------------- - <br /> Comments <br /> 1 �' L 2� 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA - <br />