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:Waste Tire Si iey & Inspection Deep 't SURVEY REQUIRED <br /> •••'•• State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> inspec <br /> Report <br /> Site Suffix: Number: <br /> I _ <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> els A 3 <br /> IE XIA MIPiLlel 1112131 :24081 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />