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: Waste Tire S� my & Inspection Rep t SURVEY REQUIRED <br /> ■��•s 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 /> TPIPP Inspection <br /> Site Suffix:- 1 1 O s o Report = ` — , 2 Z 3 7 <br /> Site Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> -V5 <br /> `a hook C es v\\e <br /> IEXIAMIPILIEI 111273 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />