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Waste Tire Survey & Inspection ReportA <br /> State of Califomla 5; +.. t [6r <br /> MINAS 183(Nsw 04104) Comments Form <br /> Cw1fomis Ittg.l.d Waste M—g—,,l Board _ _ BLUE OR BLACK INK PEN _ <br /> Business Profile _ Inspection DGWIS <br /> TPID- InspectionRepo / <br /> site suffix: , t] 1 3 , Numb <br /> Number: <br /> Inspection Number on the associated Survey form(page 1) <br /> Comments <br /> t^C l LrL <br /> c: % 3� <br /> 42408 <br /> Whb Copy.CIWMB Yellow Copy Operator Pink Copy LEA <br /> CIS 291-0 G. 1407 1 <br />