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y <br /> Waste Tire S ey & Inspection Rep SURVEY REQUIRED <br /> ••■:+�• State of California <br /> CIWMB183 (New 04/04) Co ments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile _ Inspection Details <br /> � Inspection i- -- I- -- ---- l--- – <br /> Site Suffix: I Report <br /> TPID �. Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _ l <br /> e; o <br /> �/'�'t t? -t– ��.,le�-• `— �`� �C �` l 11�us � ""_ ��v+r f�s �-- <br /> ! `— (oma F 6�Yj�lJE XIA MIPILIE1 1112E_ lbw G/ / �t�7 TIr—c J•�� <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA r� 1 <br />