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_ Bey & Inspection Re t <br /> Waste Tire SURVEY REQUIRED <br /> Li+ State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Inspection 6 6 Ll 6 5 <br /> TPID- � � _' l � � � _ � ' Report I <br /> Site Suffix: �) L Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> hJa <br /> t y <br /> Gl) <br /> i b - ar -- <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />