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Waste Tire S joey & inspection Rer SURVEY REQUIRED <br /> ••■�"` State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- <br /> C, - O Inspection _ �^� e� -1 f ,, Report I 1 V o 1 <br /> Site Suffix: L lY Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> W cti9e. 9-uo-v e" i 5`v, r" 5tvQA v)(A JQ, <br /> � � . Re.M�naus��lr� 2, 1�e,(`(��r1�c,S1 s �►� 1� <br /> 5 • l \ (A f,, UJ t S 1 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />