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=- Waste Tire SL, ✓ey & Inspection Rep t SURVEY REQUiRjd <br /> ---__ State of California Comments Form _ -- <br /> GIWMB 183 (New 04104) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> 2 Inspection <br /> TPID- <br /> Site Suffix: <br /> 7 2 7 5 v I e O 1 Report 14 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments - <br /> ilkA r, I - <br /> e �5�o 1°5 S - r cash <br /> � r <br /> 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />