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A. <br /> Waste Tire Survey & Inspection Report suRVEYREQu,Reo <br /> State of California <br /> CIWMB .-- (New04/04) <br /> Comments Form - <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> PID- Inspection <br /> ite Suffix: ID ! j 3 ® Report I / — 1 S-- <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ltb vi'e1c�aV7c or d r o crrn -� <br /> NO <br /> l, ) r,-zc- '�,` 1.�1e I� o A,� yr <br /> r_f�o c� of_ fr-r�_u � �rtx. 3�x�f�0- <br /> J– <br /> lE XIA <br /> 111273 <br /> 3 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA V47 <br />