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Wastes Tire Storey & Inspection Rept SURVEY REQUIRED <br /> State of Californik: CIWMB183 (New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - S - Inspection <br /> Site 0 ^ _ <br /> Site Suffix: Report I "yl � LA <br /> Number: J V J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> o� _,4(1 <br /> \1)3A v � <br /> -ipI rcy e <br /> 9-4004,—r� 7t)-OA 0IIA'J L--kAz <br /> JE XIA MIPILIE1 111273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />