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::Waste Tire S� ey & Inspection Reps SURVEY REQUIRED <br /> "'•" State of California <br /> • CIWMB183 (New04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> 1 _ O , <br /> inspection I 1 _ ` t, I <br /> TPID- ` "I <br /> Site Suffix: Report <br /> ort <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 42408 <br /> JE XIA MIPILIel 1112T� F:MMA <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />