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:;Waste Tire Si fey & Inspection Rep t SURVEY REQUIRED <br /> •••'4: State of California l <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection 2 2 <br /> Site Suffix: <br /> Report ` J <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> MIS <br /> 2� m® Lit, a7Ck\1A,-, � c A"r, <br /> tf <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />