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HAULER OBSERVATION REPORT <br />Ca1Rec cle �`0fu'fi`°" <br />Y erde soot tLev x=) <br />nv.orxwr finad>wway <br />O TPID - not available/not applicable <br />TPID - <br />Vehicle 5 0 5 State C A <br />Plate <br />Decal _ <br />Number m <br />(HApplicable) <br />O Hauler Exempt <br />Observation Report Number <br />IH -xx <br />BLUE OR BLACK INK PEN <br />® Observation during inspection at: <br />• Generator 0 End -Use Facility 0 Other. <br />TPID6 >a '1 3 a ��.• O 1 <br />Q Observation in transit <br />Observation by Inspector <br />M-11 - FFJOUj .GS(,OTTO <br />Observation Date To I/ F1 3 <br />Hotline at 866 896-0600. <br />® <br />Q <br />PRC § 42951 - Waste Tire Hauler Registration and Transport o£T Tres <br />O <br />© <br />PRC § 42956 (c) - Failure to Present Registratton to Official <br />O <br />O <br />PRC § 42952(b) - Falsely Represents Self as Registered Hauler <br />0 <br />0 <br />14 CCR §.18456.4 — Failure to Abide by Temporary Registration <br />O <br />O <br />PRC § 42956 (a) - RegistmborMecal in Vehicle <br />Q <br />0 <br />14 CCR § 18459 - Hauler Complying with Manifesting Requirements <br />O <br />0 <br />PRC § 42956 (b) -Hauler Using an Unregistered Vehicle <br />Q <br />0 <br />Other § <br />Comments I Driver's Statement: <br />_ <br />I�lD <br />W�5 uS�n A �lntct, SIU2 VGY1\Ci4nc� (�, c�/�. �o�ul_�J�s� I-t�nSe_J_.__� <br />_ e1 afi�- S R q `, �� s �c7 , (�t t Ste_. i f,% bn <br />- ---- -- #--?- - _-_ <br />Cafo -n 1Ip CCA\JA <br />'>,� <br />r14; n �- _ <br />wUs _- � 1;�� �tc�- , _mom», S�,_ o -- -. ?S��M all <br />- .... --- L - L l <br />Also Ei�►nr� Ul[ `ruSi'c ( W:_ ('�tn <br />Correct: Incorrect: M & 0 <br />