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■ r. Waste Tire Bey & Inspection R t SURVEY REQUIRED <br /> p'■r■3:C.■ Stateof California <br /> B omments Form <br /> - - -. - <br /> C I W M <br /> 183 (New 04/04) - <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> [Business Profile Inspection Details <br /> TPID- <br /> Inspection <br /> -. � � -� <br /> Site Suffix: r \� 1 1 Report <br /> i 1 Number: <br /> Inspection Number on the associated urvey form(Page 1) <br /> Comments <br /> ' ; 1 <br /> c <br /> 3 <br /> I -- <br /> 42408 <br /> ■ ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />