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Waste Tire S&ey & Inspection Rept SURVEY REQUIRE <br /> •� ! State of California <br /> CIWMB183 (New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection <br /> Site Suffix: 1 2 2 1 Report I l — 1 -2- <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 2A 7/7-2lz0\3 ,,lz--C-S�� <br /> JE <br /> 42408 <br /> ?� �. riot P L E <br /> White Copy.CIWMB Yellow Copy:Operator Pink Copy:LEA <br />