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• ( I REQUIRE <br /> Waste Tire St ey & Inspection Rep <br /> D1■ ::i_ State of Califomia �----- .-...-.__J ■ <br /> CIWM6183 (New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: Report I – 1/ Number: l (1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> viz) lsu4crn s- (D-y- �p r c, <br /> V -S : <br /> rj S V (14, alt i, Or S-;k <br /> (: X1 A MI P I L El <br /> 11 ZI—t 42408 <br /> � i 0 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />