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Waste Tire 'ey & Inspection Re� SURVEY REQUIRED <br /> i1;i7S State of California <br /> CIWMB183 (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: l S 2 C7 3 - Report I 1 - f / y U d (� <br /> Number: <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> 1 . _�L� LLf� � -�...n �G�Ylt./ _ / i rr��ftrY !^/�'cCk ,�`��c�✓�s:(1 <br /> 2 .) `zQ 30K <br /> lei'l 40-stn C A,(/t I ft q-, <br /> — 11In r-:7-IL s 4/y- QcU44-vtoA- <br /> 6MAQ 7-PID <br /> J 7 A MIPILIE112 3 42408 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA LIPT <br />