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41Wastea Tire ey & Inspection Re SURVEY REQUIRED <br /> CIWMB183 (New 04104) omments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- InspectionReport <br /> i <br /> `1 <br /> Site Suffix: �� �y �� -�) Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> f <br /> 42408 <br /> E XA M P LE 1 273 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br /> I � _ <br />