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Waste Tire SL_ #/ey & Inspection Rep _ .t SURVEY REQUIRE ; <br /> •••a.a� State of California - "'� <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> pInspection <br /> TPID- / ?j O C) J _ O Report I — /f �r 3 <br /> Site Suffix: <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 0 + VSD-rc Oe-� 'nc� ort1a3 C c>`✓t <br /> ✓L o <br /> ny O .GC✓YLS _ <br /> /U O tTiJ <br /> C�) '� v <br /> �� � wtu YL t�J)z t✓'P�`''� OvLJ v� a vas��.. �o �-C � n-i ,t2�c�i[�,-I <br /> J 1.- wrC <br /> r n� �'�[.�� Y1tGt.�1,��3 �t,UG1`.L l� � � � ✓Z°iVi��� <br /> JE XIA MIPILIE1 1112731 <br /> 42408 <br /> , � <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />