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_ Waste Tire S ley & Inspection Rer t SURVEY REQUIRED <br /> Stateornia <br /> N.. CIWM f183( ew Comments Form -- <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - C 1, _ © Inspection — <br /> Site Suffix: 7 _I Report I <br /> 1 Number: I O <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 11-7-71 1- ,l-7o-� <br /> r.. 0 ��,5 e� Q iv yy"T r2X �c�i en\ � <br /> h e-W ��ci 11�;,k3 � <br /> C&I �S �<<� , rzs _ ;sp �a1 <br /> Lc� c <br /> CAV <br /> o C aA` i o Y1 . <br /> 42408 <br /> JE XIA MJPJ �JEJ 1112 n3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />