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..:=,. Waste Tire S, ey & Inspection Rep t SURVEY REQUIRED <br /> •••''• State of California <br /> CIWMB 183 (New 04104) <br /> Comments Form -- <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: Z ] - Report = /' _ 2 /f -7 G -7 <br /> O {� Number: 1— <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Ozl�1t�. ti vnl LL rS C Gt.✓L�" _— <br /> ^Ntn.ti S.a., 1 .v <br /> I rl A�'L C cia�'6vv�o-✓� Cn.ti\ (N�,�A-e <br /> S ► Y,.e_ <br /> ( � <br /> — �- 4✓� t,�.a�� C2-Hjjr r <br /> �lcd,vim.�1��� G✓l c✓__�-� � � �+'t,�l., t� G� c.�._ � �G �J �' <br /> I(Yl c. E5 <br /> 42408 <br /> F XI A M SEI 117-2 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA POT, <br />