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7ki <br /> Waste Tire Sk fey & Inspection Rept SURVEY REQUIRED <br /> ••!'! State of California <br /> CIWM- - New 04104) Comments Form <br /> California Integrated Waste Management Board BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- 30Inspection3 - Report <br /> J l ' ort X11 <br /> Site Suffix: Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> ,1 �n <br /> ` AK �i Ti_4n a �� <br /> r,1A <br /> IE XIA MIDI LIEI I 1 k 21312408' <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />