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_ Waste Tire SAVey & Inspection Rept SURVEY REQUIRED <br /> "-'+=° State of <br /> B 83 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection ( /� C <br /> O / !� Report = ! — 2 3 v ® J <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> C>(- ;p" <br /> t <br /> 0- Cud <br /> CA <br /> WAA <br /> �s r etc i �% <br /> G0 <br /> 42408 <br /> f; ?( A hh P 1. E1 123 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />