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® _® Waste Tire Spey & Inspection Rept SURVEY REQUIRED ' <br /> State of California Comments Form -- <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> -- __.- ---------- _..----- -.I_ _ - - - - <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: i Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> S V, <br /> { <br /> 01 t Ci <br /> r <br /> Y <br /> I <br /> [E* }� A MI P i I el ? 42408 <br /> ■ ■ <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />