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AWaste Tire S_-. ,iey & Inspection Reom SURVEY REQUIRED <br /> ■ ■■■a.:■ State of California ■ <br /> CIWMB183 <br /> New 04104) Comments Form <br /> CalifomiaIntegrated Waste Management Board BLUE OR BLACK INK PEN _ <br /> Business Profile Inspection Details <br /> TPID- Q Inspection (� <br /> Site Suffix: S g —1 LA 5 (0 ` Report a 3 v 3 1 <br /> Number: 1 <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> � k1�c!lduI MLt�ttUcl. - <br /> �-. F�c�)� t�S s <br /> n od r �f (1A 1" <br /> WrjcT +1'4- ten�-��.s}� 44,f M(,t&A LAkhJ A Iu i 1 jL <br /> / i n�/U+ S _ Wul Wc1_'S-L, <br /> , l 1 <br /> ��9 rc,wl in rpt►� fc r�r�a n"I -r\ `7 U nColl-,' <br /> S <br /> 1i f C,S G f 40AJA (A 6& � 11 1':�l �0 1), <br /> JE A MIPILIE1 42408 <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ■ <br />