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■ Waste Tire E#ey & Inspection Ret t SURVEY REQUIRED <br /> 1ii33S State of California <br /> CIWMB183 (New 04/04) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK P E N <br /> Business Profile Inspection Details <br /> TPID- J Inspection <br /> Site Suffix: Report I 1 - I 2 2- <br /> Number:Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ✓C���ldA�7`�/�'7 f" !'�"Y QiYC�.t � C�� ��lyl CI..I�i�� <br /> �V11�1CS <br /> fix}1Q[ i�G[¢ -S WGcPI-G <br /> _,4 CxI��tLltpl-c_ <br /> �C !r"Ie <br /> roc k4-trigice/ <br /> - /V l d _ t —L —�� - �ie`Gk K�Cc�'T e� A&N z <br /> dre- no laurgZy C2egtA <br /> 42408 <br /> 1E_XjWMjPjLjE1 III <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />