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:Waste Tire SL. ✓ey & Inspection Rep, SURVEY REQUIRED <br /> ■••�'• State of California <br /> CIWM6183 <br /> New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> - e ® Inspection <br /> Site "L _ 19, • , <br /> Site Suffix: Report = (f11 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> No�w 1, cx4l e 4c <br /> ZA�11 <br /> eA <br /> -- - �b- ori;� <br /> U0 OV 61jr,\ !:�l <br /> s e/A l Ste_ <br /> �� — <br /> jrXIAMIPILIel 1112131 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />