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:.. - <br /> Waste Tire SL ey & Inspection Reps j SURVEY REQUIRED <br /> ■ ++ ■■ua• 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- Inspection <br /> ! 6 ? O ` Report <br /> Site Suffix: I — 1 ` 1 8 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> c w <br /> JE <br /> 42408 <br /> A r� r Lt 12 <br /> r <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />