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=Waste Tire St rey & Inspection Rep SURVEY REQUIRED <br /> k••!;t• State of California <br /> 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 /> TPID- Inspection <br /> Site Suffix: �j - Report I L/ <br /> 1 _7 � � 4 � S ® l Number: � � I <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Ct <br /> -h <br /> c <br /> 4" S <br /> Ld <br /> 11` <br /> i <br /> I <br /> E; A 1 3 L 3 Ir 2408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA as <br />