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U.-: Waste fire purvey & Inspection R( ort <br /> SURVEY REQUIRED / <br /> LERVI'�.• State of California <br /> -_- <br /> I - <br /> CIWMB 183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: '3 5- I 2 c-) Report I I — I Z S 1 8 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> I�� lt / .SC t3rid <br /> Dab <br /> 2/�l IS- d to 1000 l <br /> JE <br /> ABLE 1_[2731 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ;—!Uj <br />