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°e ___ Waste Tire SL.- vey & Inspection Rept SURVEY REQUIRED) <br /> •••!._ State CIWM ofCaliforniaComments Form <br /> CIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: - �* i Report I — 1Z ! <br /> rJ 1 Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ���-���-t-tom � �7-� -t�' ��-s L 1/�� ,v, 3C v►�.�� t' ;���s <br /> ` C" <br /> 42408 <br /> jEXjAMjPjLJEJ III3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />