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__ Waste Tire gWey & Inspection Rei 't SURVEY REQUIRED <br /> •::�: <br /> Stat eMof California Comments Form <br /> CIWB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile_ Inspection Details <br /> TPID- <br /> Inspection - <br /> Site Suffix: 1 -7],--44 7 ( Report I I ! ( I 8 I P I <br /> _ Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _ //��ticle 1 <br /> a, Sze . n P Z t-*- a 1 t,(p 1-2iIC.cJ !-,,n <br /> �C) -�J-L o�ck�I.-Q)nC,r -ra"Q s nT C a r,c E r h -• - - <br /> 2 <br /> JE XIA MIPILIE1 111273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA r� 1 <br />