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Waste Tire SL ey Inspection Rep SURVEY REQUIRED <br /> ■ '1;;;;S, <br /> r®i33Z■ State of California ---- -- <br /> CIWMt3183 (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: C) Report I — !/ x 6 5- 7 <br /> Number: .1.- <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> �n v-ra����,�,�zz��rr� ems.- -��.��. i'l-► <br /> ar !Ty rtJt1S d� C C►rYL C 1p----�; - � � .---- --- <br /> ore T <br /> - s <br /> a. <br /> I-EXIAmOPME1 1 '- 42408 <br /> ® White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />