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a Waste Tire Sey & Inspection Ike SURVEY REQUIRED <br /> State of California <br /> k"..».: 'e CIWM6183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- _ Inspection <br /> S'.te Suffix: t i - Report <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> ti f'":;' <br /> le XIA MIPILIE1 1112131 42408 <br /> ■ <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />