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Waste Tire S, iey & Inspection Rep SURVEY REQUIRED <br /> _ <br /> State <br /> ka <br /> CIWM f183 California <br /> (New <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 /> O Inspection _ G 5 <br /> TPID- ` t,t � � ( _ (� v � Report I <br /> Site Suffix: I —1 �J o o Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> Ilk <br /> ! G4 <br /> (c,(U fc <br /> i Z ► <br /> ulb <br /> <<-7s 6 - I' <br /> 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pin ■ <br /> k Copy:LEA <br />