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■ kz <br /> Waste Tire S dey & Inspection Rei SURVEY REQUIRED <br /> ■ <br /> State of Califomia <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- —7 /� inspection <br /> 1 S 1 ` f �l _ V Report <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> JE XIA M111"ILIE1 111 <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />