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Waste Tire G"-rvey & Inspection Fla.Wrt SURVEY REQUIRED <br /> '1_ State of California <br /> CIWMB 183 (New 04/04) t,omments Form <br /> CallfomlaIntegrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: L� J Report I _ I CR / �f <br /> Number: �✓ .L <br /> Inspection Number on the associated Survey form(Page 1)� <br /> Comments <br /> - i4ic,tci it eas Ate <br /> --- I . <br /> r 00 IF <br /> _-&ko- e r Ale me <br /> q —A -�-l9-:-o`er_-1.s�c�C) --�,� +„w S. <br /> To <br /> IE x PILI i 1112131 :2408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />