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--- ----- ---- <br /> Waste Tire Ste.. vey & Inspection RetSURVEY REQUIRED <br /> koul <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 /> Site Suffix: (� Q �j Report I /J — /, /� 6 <br /> Number: L <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> o <br /> Duo <br /> crz 1 - Gam - ti <br /> ICA, Lir <br /> Ayl <br /> ZI6�b7I5-C-A <br /> l -tem .. <br /> ice_ G. yr�l rlrt t�1 c.vlrl -�� z'Gz.,. <br /> 42408 <br /> E XIAtilt P! � EI I 1 ( ? 3 i <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />