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Waste Tire : vey & Inspection Re A <br /> SURVEY REQUIRED <br /> ■ - . Sate of California <br /> Lt <br /> ■ <br /> UZ CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> usiness Proflle Inspection Details — <br /> PID- Inspection <br /> Site Suffix: 1 J 0 3 ` Report I — _� <br /> Number: <br /> inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> f) iyn>pechi r <br /> J:i?,-x7.s cy A/r-ce-x In <br /> 7P <br /> +WcS Cum S, �P lV© �,�1��' LY -a3cc <br /> 41D _ C ', 1'Y1 <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />