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:Waste Tire SL jey & Inspection Rept SURVEY REQUIRED <br /> ••••''• <br /> State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> CalifomiaIntegrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- z Inspection <br /> Site Suffix: 3 J Report I Z 2 I <br /> O ` Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Oo50CA <br /> � o lt�5-61A � ll-p--r�2 <br /> q.. c�clCaV I'mss <br /> jeXIAMIPILIE1 1112131 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />