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Waste Tire SL ey & Inspection Rep t SURVEY REQUIRED <br /> •••'` State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Q Inspection <br /> Site Suffix: 6 kA V s 1 Report = — 1 3 0 Li <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Al <br /> C <br /> Ca !*,,,, t,���•e <br /> JE XIA <br /> I <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />