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ry Waste Tire S <br /> tey & Inspection Re SURVEYREQUIRED ' <br /> ® . .. State of California <br /> - -� Comments Form - --- <br /> - CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> -_ _ <br /> TPID- r Inspection <br /> Site Suffix: f% ! , Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> Ij <br /> II�:,T!,'� ,l((i i_M - n n/->t r•,�L� J /' r: ✓� � Jr C-t:f�.,r �' � . � j-����1�' t - <br /> b <br /> / <br /> "srzjii'((tf1L (1 `.1.. ' 2.i_i <br /> I -� L <br /> ii <br /> i") V' {,dt! 1 -.`✓` t (;'i' .'fir E r Ji i•_ s l . '+ �'' <br /> j..l J l ! / 1 / r 'i % �•' i fl l G:t �` 'i 1� l _. <br /> tl <br /> 1 — <br /> tj`'c <br /> ;Ct f _ _Viv,r J <br /> 1 1,-{ ,o -�i. -f_�! f(! (.t ! !r' I Y��.{__ { ,_.:i.. ..� :, I V fy F- f�� (' i j ( I ' _ 1�• t _ <br /> to Ij <br /> ;— y. f <br /> IfOT <br /> 42408 <br /> le X1 lel I I <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />