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_ Waste Tire SL ey & Inspection Rept SURVEY REQUIRE <br /> rrrs.c State of California <br /> CIWMB 183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> 'Z <br /> Site Suffix: 1 g L C) ® Report = _ 1 2 , o Q 3 <br /> Number: �l <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> av4�- Nna.�,\cK <br /> Ns-rck-1. OA- �A2,W <br /> S (fir q-- <br /> IF <br /> 42408 <br /> :K A NI Z <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />