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:ka <br /> Waste Tire S�ey & Inspection Rep suRVEY REQuiRED <br /> ■ State of California � ■ <br /> CIWMB183 (New04104) Comments Form <br /> Callfomla Integrated Waste Management Board - BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> Site - I 3 6 $ V _ — Inspection _ 7 O <br /> Site Suffix: Report I <br /> � b 0 1 1 7 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Mn4�eS twos ). �)M 5t cv;c R <br /> c <br /> ? FTS-S c 01r� �1a�Sn t.� av w c e- v �412d. <br /> .yPIh <br /> 5> ,1c2 0.05. <br /> tit J wa SA!!!!t k- re-S - T1n��j c. �,i f are Oynk-y <br /> o- �-�n: S to C CA-1- <br /> 42408 <br /> AM� LEi 3 ■ <br /> r <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />