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ire Sle & Inspection Repo SURVEY REQUIRED <br /> . Waste T Y _ <br /> •••'�• State of California <br /> _ CIWMB183 (New 04104) Comments Form BLUE OR BLACK INK PEN <br /> Business Profile <br /> California Integrated Waste Management Board <br /> Inspection Details <br /> 1� Inspection C <br /> TPID- ` O _ 1 - 0 I Report I - �, J <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 7) <br /> Comments <br /> IL LAZU, <br /> 1 � <br /> -00 <br /> 42408 <br /> r <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />