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� _ _ Waste Tire , Sovey & Inspection Refit SURVEY REQUIRED ■ <br /> ■._+tee_ State of California <br /> - CIWMB 183 (New 04104) , <br /> Comments Form _-- - <br /> -- <br /> CalifornialntegratedWasteManagementBoard BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- J Inspection <br /> Site Suffix: ? J/ ? Report I <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> WJ <br /> JE XI��� 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />