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__ Waste Tire Sl.0ey & inspection Rep SURVEY REQUIRED <br /> '•• State of California <br /> CIWMB183 (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 /> (' u <br /> Site Suffix: _1 g q Report12 6 2 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 1�9e�` \� "� `' �.� -��Y_�n .-Ccr."���f►��:<ZZ�-�_ �G�S�. <br /> �1nSc <br /> le XIA MJPJ �JEJ 111273 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA e 1 <br />