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4IWastea Tire Su vey & Inspection Repot SURVEY REQUIRED <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - C) 5 S _ < 1 Inspection � — <br /> Site ffi <br /> Site Suffix: J t Report I1 <br /> Number: l <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> NP <br /> le <br /> 42408 <br /> A PJ � EI ill <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />