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Waste Tire SL. sey & Inspection Rep, SURVEYREQUIREDI <br /> ■ "::: State of California c <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> TPID- 5 �) m ® Report I 1 — I I q <br /> 3 <br /> Site Suffix: 5 "� Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> t <br /> 3 . Tri� l c S ` u�1, <br /> _ A P T 42408 <br /> ■ �i <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />