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Waste Tire Si ,ey & Inspection Rep + SURVEY REQUIRED ■ <br /> State of Comments Form CIWMBmm <br /> 183 (New 04/04) 1 1 11 1 1 <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Report <br /> Site Suffix: / ,z © <br /> Number: T <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> /r�U GnLyLG�i G�YLC G!Y GiYt-LGC Ci ��YZC[�f"� - <br /> �_�� 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA Pa� <br />