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XWaste Tire SL ey & Inspection Rep [SURVEY REQUIRED <br /> ,iir State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPI - Inspection <br /> Site Suffix: I6 / 77 3 3 Report , I 2 7 w <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> • r2C0�� 5 �L`G S Cti�n <br /> 42408 <br /> � A 2 -1 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />