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Waste Tire S—ve & Inspection Re ^ °t <br /> y p Rep^"A REQUIRED <br /> ■ 'G=7� State of California asizs:ir� ■ <br /> CIWMB183 (New 04/04) l..�mments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> _Business Profile _ _ Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 4o 3 Report = ` _ f � '7 6, <br /> Number. <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> _ /at4J%a-�.S � -f,�>�r D� Ca��1.o-vim <br /> - '���'�� fs ay, �flr� ccc.�,�Y� ���i�_ss fZtc�.� J�•r��S _ <br /> 1 0 rrAA4& mat &r^rt <br /> —moi ��y �►- �ua�r�r�,/�' /��.�p-rn r �'l�a�.f' �G��.� fi-z�S'c�c,H v n S <br /> 10.4 c q<zw <br /> � 42408 <br /> lE° 1 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA V—MTM <br />