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Wastes Tire Srey & Inspection Rep t SURVEY REQUIRED <br /> State of CaliforniCIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> InspectionTPI <br /> - , ® _ l Report <br /> Site I 1 L 1 1 I <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 6Ck-& :tee • <br /> `712-$L\ - <br /> VN <br /> 'gyp ci�VJ--. <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />