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Waste Tire Sl e�/ �c Inspection Remum <br /> pt SURVEY REQUIRED] <br /> • State of California Comments Form - -- - - <br /> CW <br /> MB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- ll- Inspection <br /> Site Suffix: I V 5 1 ® Report = — Z , 037 <br /> 1 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> SC) <br /> A,e_�e _oh <br /> sit <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />