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lWastea Tire S ey & Inspection Rep SURVEY REQUIRED <br /> State of Californi <br /> CIWMB183 (New 04/04) C+ ments Form <br /> _F California Integrated Waste Management Board <br /> 9 9 <br /> BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: _ - Report _! . <br /> _ - Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> 'Comments - - <br /> I <br /> F A MJP, LJEI 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />