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■ __=q.- Waste Tire SL & InspecUan Regi t SURVEY REQUIRED ■ <br /> •"�;• State of California <br /> CIWMB183 (New 04104) Comments Fora <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: l O 72- I 2 l m 0 1 Report = - t Z 3 ® 3 6 <br /> Number: J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> C��� <br /> co <br /> hi k5 <br /> kA Y�, <br /> JE A MIPILJ ; 111273 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />