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ka <br /> Waste Tire Survey & Inspection Report SURVEY REQUIRED <br /> State of California - <br /> Form - <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> usiness Profile Inspection Details <br /> PID- 1 Inspection <br /> Site Suffix: j 7 j Z - / Report = – <br /> Number: ' <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> c; % <br /> 1 / �,t'• ,� (,t. rrt�'cl�i,,.,(O. .�yc�.���_c�- /SSS � . �/�lu.�r S.f . s`� <br /> J <br /> —���rr✓ cs eefJ���r`. Sii t_el laves AAd a ' <br /> -- nuc. !�`r i -c✓P o/ �r s r� � Ape x az,,--a <br /> J <br /> �Lt.c. rtr}ar�rtc.� L�uTtd � - <br /> Nd—Aci�� A-4 —"a 5- 422!� 7qkC 24=42 <br /> % <br /> Z <br /> J A MIPI L EJ 1 ; 273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />