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Wastea Tire S ey & Inspection Rep Yt SURVEY REQUIRED!:U! State of Californi ! <br /> CIWMB183 (New 04/04) 4mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: j �T }_ S Q Report I 1 — ` n , 6 z 9 �i <br /> Number: fG, / <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _ L il1v Lc&Atcm r, o-r &4-e4+r p/- Lo77CZ-,Vy. <br /> ©kr <br /> 14-ce(• A— / lit /I�r fii4 rxt k,,r— <br /> i <br /> i <br /> JE�Xj <br /> A j L 25 42408 <br /> White Copy:CIWMB Yellow Copy.Operator Pink Copy:LEA <br />