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_ . Waste Tire S ✓ey & Inspection Rep 't SURVEY REQUIRED <br /> X333 • State of California <br /> CIWMB183 (New04l04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection = 2 <br /> Site Suffix: Report f — L L Z 1 <br /> TPID- / , Number: 7 / <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> el—L C,.S �9�A4A MA, =TIM <br /> tiA, J S Z <br /> �-� — <br /> V,� w- <br /> +, 42408 <br /> F AM,IP � 1j2 f <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />