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LM <br /> Waste Tire S ✓ey & Inspection Rep t SURVEY REQUIRED <br /> "`.• State of California-_- Comments Form <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection <br /> TPID- J Report <br /> Site Suffix: -7 `) G l Number: - U <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> a t <br /> A(r��- E` <br /> r ff� <br /> C_ <br /> Y <br /> 7A G <br /> e Ar <br /> t � M <br /> e <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />