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N. Wastea Tire o <br /> ey & Inspection Rt I SURVEY REQ!!:-4. State of Californi <br /> klurzy UIRED <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board _ _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- I tion <br /> Site Suffix: -5— Report � � z <br /> 'T <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments �W14 /-C> /o/o/s- z <br /> � 42408 <br /> A MIP I_ Ew I 1 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />