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Waste Tire #e & Inspection R i t 0 <br /> ____. Y p SURVEY REQUIRED <br /> •::'�� State of California <br /> CIWMB 183 (New 04/04) <br /> Comments Form - <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- 1 t Inspection C <br /> Site Suffix: "� (p Report J s <br /> Number: i V <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 8—[ <br /> dos,d- <br /> 0\j <br /> JL 4 1315 a <br /> b <br /> IEXIAMIPILIE1 WIN <br /> 42408 <br /> ■ White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />