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-11 <br /> AWaste Tire SL ey & Inspection Rep SURVEY REQUIREDI <br /> •••`• 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: ` - Report <br /> ✓ O Number: ' <br /> Inspection Number on the associated Survey form(Page 1) <br /> Comments <br /> &)o�, � Xe-=-7,7S G� C, As <br /> �S� rr��.��� �-��e� t�C.c� �-roe,✓. <br /> Q', S <br /> doh. <br /> 42408 <br /> r �White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />