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Waste Tire Survey & Inspection Report <br /> ■ li=ly—Slate of California :,3.�+r...'R i:.S°-rte: r ■ <br /> �l ClWM (Naw04/04) Comments Form <br /> c.f.rnia Integrated waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection Report ^J L <br /> site suffix: 1 Z © ID <br /> , Number: I 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _MEN � <br /> N_tN�A� rev. v�'1r�:& <br /> ^ Llfrr— C a tc�L�Q�\ •lJ�s�.s�t�tC �� <br /> �(ILbA -tJ'°� �✓ <br /> •� W a v t of a,���-S <br /> 42408 <br /> ■ EXr�.MPLE f 23 � ■ <br /> White Copy CIW MB Yellow Copy:Operator Pink Copy:LEA <br /> 0529206.0060 <br />