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Waste Tire Survey & Inspection ReportSURVEY REQUIRED, <br /> •••'�: State of California <br /> CIWM6183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - ry� _ A Inspection <br /> Site _ <br /> Site Suffix: b 1 Report I � � 'L 3 /� b S 7 <br /> Number: J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> t�2� <br /> C . <br /> JEXjAMjPjE I 1 J Z 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />