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Waste Tire Sorey & Inspection Rep t SURVEY REQUIRED <br /> Statof California <br /> e <br /> CIWM6183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile inspection Details <br /> TPID- � � � q � Inspection� _ <br /> Site Suffix: / Report I z r_- o I 7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> vao +i <br /> k -5 <br /> 42408 <br /> t <br /> White Copy.CIWMB Yellow Copy.Operator Pink Copy:LEA <br />