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;:" Waste Tire S�,_ ey & Inspection Rep <br /> '�:�.� SURVEY REQUIRED <br /> 2!!•• 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 /> - 0 5 7 _ Inspection <br /> Site _ 1 <br /> Site Suffix: IN <br /> eport <br /> umber: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> Cs�v� � -_ <br /> 1KY - <br /> ov- <br /> 42408 <br /> JE XIA MIPJ LJEJ I I I De 7 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />