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= Waste Tire SA►ey & Inspection Rept SURVEY REQUIRED) <br /> 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 /> TPID- Inspection <br /> Site Suffix: , 2 J 3 I 1 I Report I t — Z ' 0 1 6 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> c-py,rL �l�312 <br /> �5 a. ion <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />