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6� <br /> .. :Wastes Tire S y & Inspection Rep SURVEY REQUIRED <br /> State of M <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPI - - ---- f Inspection <br /> --- <br /> --, ( �- Report <br /> Site - I i <br /> Site Suffix: iii <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 42408 <br /> ■ e A PI e� 1 2 3 ■ <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />