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LSURVEY <br /> ___._ Waste Tire S&ey & Inspection Rept REQUIRED] <br /> ' State of California -- <br /> CIWMB183 (New 04/04) Comments Form <br /> califomia Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> 77- <br /> Site Suffix: 5 5 S Report I Z 9 <br /> Number: <br /> Inspection Number on the assoc ted Survey form(Page 1) <br /> Comments <br /> -TRIX-) —cx-f—vs-kvcp��e— N5 Ros" <br /> rn <br /> 3 . <br /> a c \mss <br /> oxe- <br /> C1 0 <br /> A C <br /> CPtfe. S <br /> Q <br /> > � -- <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />