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Waste Tire S#ey & Inspection Reret SURVEY REQUIRED <br /> ' •: State of Califomia -- - — -- <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: <br /> 1 O � J - Report I - Z— S-2 <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 00 mss <br /> 7-1 � � <br /> a ec ykC - talcs F::5 V--A� _ <br /> QUC .t.t"�C L L;ki.tre <br /> , �!. �'+ tom► kit--—4t <br /> 70 4-) <br /> 42408 <br /> JE XIA MJPJ �JEJ 1112131 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA rJ <br />