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Waste Tire S1 ey & Inspection Repw <br /> suRVEY REQuiRED <br /> ■ ■■■■ ■ State of California - ■ <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK CNK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: I I l j a ( Report <br /> Number: ! tl 1J J <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> rt- coafad r <br /> k. <br /> ,C 06 llvn <br /> _ P-0 _t,0 hrt f) on 0 C lis TP i D -5; u 5 a <br /> s? waw � i,��_ V'o) a -e <br /> 42408 <br /> E 3 kM Pj E IZ� <br /> White Copy:ClWMB Yellow Copy:Operator Pink Copy:LEA ■ <br /> ( <br />