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... ___ <br /> MWaste Tire 5, ✓ey & Inspection Re t j SURVEY REQUIRED <br /> _ State o (New <br /> fCalifawe <br /> Comments Form <br /> •Y •� CIWB183 (he04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN - - <br /> Business Profile Inspection Details <br /> 22 Inspection <br /> TPID- , J Report = <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments — -- <br /> STS <br /> t <br /> v -- <br /> ---- <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />