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_ Waste Tire S&O & Inspection Rep SURVEY REQUIRED <br /> ■ !!—I! State of California <br /> 1,121 CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 1 -57 3 5 Report Q <br /> Number: 1 V <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> co- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA r <br />