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Waste Tire Survey & Inspection Report SUR1V <br /> • ,.• i State of CNHomla /'� rye C <br /> CTWMB 181(Nert8Uoa) Comments Form <br /> California Integrated Waste Matt"# ntBoard BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> site Sutrtx: l-3 1 9 I / T� - I �Vl <br /> Inspection <br /> em on I _ Z i It <br /> .1 Number: i_ _ t- _I _ 1 J_ 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �G �1 �a�.►C 033��o J. <br /> --- l�9Jve8 0338 <br /> - <br /> ■ EIX AIM P L E 2 2 3 a2aoa© ■ <br /> White Copy:CIWMO Yeltow Copy.Operator Pink Copy:LEA <br />