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.Waste Tire Sigey & Inspection Re pst SURVEY REQUIRED <br /> State of California Comments Form <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: k —7 7 c\ / Z O Report I 1 t U <br /> Number: 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ��� w,•,llz.��, <br /> 'fir c�.c � N-1s <br /> Gil <br /> �l2.v�2vJ <br /> JE XIA MIPILIE1 111273 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />