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MlWaste Tire Sum - ey & Inspection Re <br /> {7c SURVEY REQUIRED <br /> !�e! State of California <br /> •! -- -_-_-- -- --- <br /> COMB 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 /> 1 L f\ � � � � o � Report I <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> C <br /> X6$01 _ C--)l\ lS <br /> Y\. <br /> o v�,c Se_ a-i c.- <br /> iS <br /> 42408 <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />