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: Waste Tire S ley & Inspection Rept SURVEY REQUIRED <br /> State of California <br /> CIWM6183 <br /> New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Inspection <br /> Site Suffix: 1 � 6 3 3 Report I l — <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 0- VCA,-? ef kcv C),A- <br /> le XIA MJPJ �JEJ 111273 <br /> r� <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />