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Waste Tire Survey & Inspection Rei rt SURVEY REQUIRED <br /> WigState of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: ( 3 (ci ' Report = ' — Z- S- `j C ' <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> N f <br /> Z--� A- CTL. La , <br /> alU <br /> Aj- <br /> CD c <br /> s) Fat,-) 11�4 c <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />