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0.9 <br /> Waste Tire Arvey & Inspection Rep�l"t SURVEY REQUIRED <br /> •i•'si 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 /> Site Suffix: �. 6 Number.Report <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> `i1'Le <br /> rk <br /> ■ �h Ix R� F L EI 1112j3 42408 <br /> White Copy: IW Yellow Copy:Operator Pink Copy.LEA <br />