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Waste Tire Sftey & Inspection Rei. SURVEY REQUIRED <br /> Lirlizil•'ar State of California <br /> -- <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 /> Report = _ O , I <br /> Site Suffix: �( <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> y _ � r � <br /> �U R � S r y r � � G CVlwh_6 <br /> Irr l 2 3101,e-Wu <br /> 1 <br /> L\ <br /> J � p <br /> Zbs Inn -hA (A 4C <br /> ))jc,s ��Vm Ik �)C_j '<_Alb) M I )0� A+ <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />