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Waste Tire S Y p& Inspection Rep <br /> SURVEY REQUIRED ' <br /> ■d++,.es State of California <br /> -��- Comments Form <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile I Inspection Details <br /> ICT) Inspection <br /> TPID- �' — - ReportSite Suffix: II qE� Number: I G • } <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments " <br /> a — rj c' <br /> L-2116 <br /> , <br /> i <br /> } <br /> 42408 <br /> IA1P ISI 11121,31 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />