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:Waste Tire S wey & Inspection Rei. ,•t SURVEY REQUIRED <br /> •••��� State of 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 /> TPID- Inspection <br /> Report I I <br /> Site Suffix: �j ( _} V Number: �— <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> co-1 <br /> AAa <br /> il <br /> hY <br /> Z- If 1,Y1.9- <br /> T M- <br /> 14 <br /> wttti Ins <br /> 42408 <br /> 1E XIA MIP11el 102T31 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA F:eA <br />