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is <br /> Waste Tire S ✓ey & Inspecti®n Rer i SURVEY REQUIRED <br /> State CIWM f183 California <br /> (New <br /> Comments Form <br /> CIWMB 183 (New 04/04) Comments, <br /> Callfomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Bu 'ness Profile Inspection Details <br /> TPID- , p _ o _ Reppection <br /> o Re ort l� <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> MON <br /> 1 c;5 Wt., 4 <br /> (wAorf\c-f s i) <br /> FE -1 A--M����� :2408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />