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Waste Tire S�._ ✓ey & Inspection Rep, . t SURVEY REQUIRED <br /> •"•• State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 5 - Report <br /> © O Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �•,C �P�.s�t kl <br /> v Cc.v�- em (3(- <br /> A\ <br /> rA\ �1� c7�� �'+�S v�nvS�t 64? CeCt`Pc�cr <br /> (0- <br /> 0 <br /> �5 <br /> IE XIAMIPILIEI 11 1213M 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />