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=I Waste Tire SL & Inspection Re <br /> p � L�,EY REQUIRED#�_ _ State of California -- --- -- <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- ( G( Inspection <br /> Site Suffix: 1 I © ' Report I — 1 2 1 O 1 7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ac�ndk - lie.-�2., yv�. ,:rS �-�c.r� ►.e h�'�,i�3S ��-S CJ e c�o <br /> 'tce� Hca �1r.�S ? �\. <br /> 42405 <br /> EF . A MIP! L II z n3 f <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />