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Waste Tire SWey & inspection Rer tSURVEY 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 /> m ® Inspection <br /> TPID- _ <br /> Site Suffix: ` Report <br /> Number: v <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 5Q-t> Wu,., AVg I 1A bL <br /> Gwi e Al_ <br /> klie- <br /> t <br /> S _ <br /> I1 '-Jf ns <br /> 1EXI42408 <br /> ANIF t - i <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />