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_ Waste Tire S. rey & Inspection Rer t SURVEY REQUIRED <br /> •:_'�• State of California -- <br /> CIWMB183 (New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ` ?S 1 l Report O 3 d <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> `es _ O` s �JteC W yi CSA- c> 1'L, <br /> �j•J :S �1 <br /> \,n,C- 0vN1EXIAMIPILIE1 111- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />