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"Waste Tire Sorey & Inspection Rer t SURVEY REQUIRED <br /> ••''`• State of California <br /> CIWMB183 <br /> New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- 2 p ` Inspection <br /> Site Suffix: ' J O d Z 1 Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> N \jAM7 deo-ccs c�ov2 oc :.5 �ac�\:�N covv� <br /> IE XIAMIPILIEI 1112131 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />