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■ __Waste Tire S', ✓ey & Inspection Rep i SURVEY REQUIRED ! ■ <br /> ••"i• State of California <br /> ----- Comments Form - ---- <br /> CIWMB 183 (New 04/04) <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: r ! �T Report = _ I zi i o <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ��J I�CAJ Y <br /> ,I It, rn <br /> 3.) t,t�;c 4 sY--s, nub <br /> -w <br /> " A M S 11 ' 273 <br /> 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />