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Ellil <br /> Waste Tire S vey & inspection Re[ 't SURVEY REQUIRED <br /> State of California CIWMB 183 New 04104 <br /> I I Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 2 C- Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> --n i f 4 a.fit^nS :i4 _'TT I D lob' Iso-, —o f <br /> iJc��kr <br /> _- 6 in v n;ca r 'y �u�t��.t�sar�__ t yt.ca c rr . ,�F-t•ate CLQ Q- 4xj cwt k- <br /> -- _ 4nx� z C N c C1 S1 j , f�mf cA,rAur S' <br /> 1 f T P 10 C,12y -t-CCA--� <br /> 42408 <br /> JE XIAMIPILIEI 111273 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />