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Waste Tire Si ey & Inspection RepSURVEY REQUIRED <br /> ■ ::::�. Stateof 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 /> Inspection <br /> TPID- <br /> Site Suffix: © L( � Report I t <br /> l Number: 111 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> A ' <br /> gak,3144-7- A '70 <br /> If 0"Z7-5- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />