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Waste Tire SL_ Bey & Inspection Rep... t SURVEY REQUIRED ■ <br /> ■ ■.■..r: State of California <br /> COMB 183 (New 04104) Board Comments Form R BLACK INK PEN <br /> California Integrated Waste Management BLUE 0 <br /> Business Profile Inspection Details <br /> Q Inspection / I <br /> TPID- �1 U _ ® I -- Report I 2 1 (n 3 l 5 <br /> Site Suffix: J Number: v <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> wl <br /> 5 <br /> Cr <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />