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■ ":::Waste Tire St— vey & Inspection Rep_ A. 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- InspeC - Report <br /> tion <br /> C = _ Z <br /> Site Suffix: 6 � � � � � Re ort <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> N <br /> r <br /> Line <br /> A Ina c:V\if [` l <br /> Ch <br /> J 1 ' <br /> 223 1-0 . lin <br /> �p <br /> 42408 <br /> E X �- 1 1j2131 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />