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Waste Tire S&ey & Inspection Rep <br />■••'�• State of California <br />CIWMB183 (New 04/04) Comments Form <br />California Integrated Waste Management Board <br />SURVEY REQUIRED <br />BLUE OR BLACK INK PEN <br />Business Profile <br />Inspection Details <br />TPID - <br />Site Suffix: 15 a Z 1 <br />Inspection Q <br />Report I I 1 — 2 0 C� <br />Number: <br />Inspection Number on the associated Survey form (Page 1) <br />Comments <br />_ V <br />�/(� (moo �['�. ` ` j� o \ C � • ^ �/. <br />[n <br />—_ rl bb�kti��es v�SS2 S ok CCR. �'C� `� �� A %\ _ <br />_�--�_�'��s-ems vim- Y 1 ,69 <br />—Lt-r- c2 -GW- 6�C�b (--\ <br />GA 1 y ems—\ --t �� ra • \ Y1 I TL�� � <br />a 1m Xoc V.eaCS <br />leXIAMIPILIEI IlIZ73 <br />White Copy: CIWMB Yellow Copy: Operator Pink Copy: LEA <br />42408 <br />