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HAULER OBSERVATION REPORT Observation Report Number <br /> CalRecycle ytle <br /> xxx <br /> BLUE OR BLACK INK PEN <br /> iiia� F. IM1r1 t y�zr4h r a r( �}Z <br /> s :•r, n,._f fh 4.tC. ��, •.,> ,. 3+,.�• r r ,f,. :7.`�'. i"3► � ul,ti <br /> 1.2 <br /> O TPID-not availablelnot applicable 3 rari s C� <br /> , ' <br /> f Observation during inspection at: + 1 ``b <br /> TPID � (� g 3 <br /> _� 0 Generator O End-Use Facility p Other. <br /> - 1 (� 7 C7 <br /> Vehicle State *TPID= g � _Plate 1 Q Observation in transit <br /> Decal Observation by Inspector <br /> Number -3 q _ 5]O ' i .m AT 1 Q <br /> (NApplicable) <br /> Observation Date <br /> Q Hauler Exempt: <br /> Hauler Name Observation Time <br /> , lf< • A" <br /> Hauler Address � `'ice O Pµ <br /> Street <br /> S��kkoh C� qS 2oS <br /> City State Zip Code <br /> Driver's Name D.O.B. <br /> Location of Observation <br /> Zg 644• S.Trr�,Gy.. gl�c�.• _ . , . <br /> Street <br /> 1 t^a c Y Cit `15377 For more information concerning Waste/Used Tire <br /> City state Zip Code Hauling&Manifesting,please call the Waste Tire <br /> %;F r E01-11 Hotline at(866) 896-0500. <br /> fir.. <br /> s �* st ,41 flr��;1,❑�7 l. Y. 6 t�.{lA .r..i il: <br /> Part B - <br /> 1111 M1111111i'lMM" <br /> �4 , ' <br /> O Q PRC§42951-Waste Tire Hauler Registration and Transport of Tires O © PRC§42956(6)-Failure to Present Registration to Official <br /> O O PRC§42952(b)-Falsely Represents Self as Registered Hauler Q 0 14 CCR§18458.4—Failure to Abide by Temporary Registration <br /> O O PRC§42958(a)-Registration/Decal in Vehicle O 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O 0 PRC§42958(b)-Hauler Using an Unregistered Vehicle Q G Other§ <br /> Comments/Driver's Statement: <br /> '��uGr�_ib._..SSt�a.�.ink.�5��-tsz`l�._.A�S._�5�'__.SS�.v�� .��-`.'.��1q �c\` C7���2?�_^._.— • <br /> Q �ce,_�Cam <br /> _..p�Str_._t�wc.�oc�-._ �_�?�__..b����-Z�.��Z=..�5..�.•e_._.�,_�'�..sZZ..laces.�:.�.��Ts_.._.���.,__--__.__.._..__. <br /> x�:. �c'�' &.1���.. .Gv�c ._,.�.�--�_we�-_�___�'�_. � _ . .__ �S�•z. cam. :^..���--..__.__ <br /> r. rt. '� k�....k§ e MW..�. , . 7,�JA � 't,,i {,tk� Uk' uTyS'�",lk,~y va t} }7) 7 d7; �d { 1` �lkr}�" M �a�yJ f:5:�F llr i 1 ac&.i ril hf e+ �7 �,� v r l , nl � r�.pr's r'... 19i <br /> ;'� �°1= I ,:xAri er's7 triure k>Pone ' a I� yl �cos§Sl n� re� Ft,1 honeR "��BC� <br /> �, t I s• �y+.9. � a r K}t , r� t• • di•c t r, ft � i � ITT' <br /> wk <br /> .• �ti. �' � �1-.,r5 i. :.t 7 1,J <C.: a.�., .5... .3.i�.yi',: ,...t..Y...k �.:.2 ?...'r!E .Ll.f.,r.i. .. ., �".�. ��F1'i:•.Correct: 0 Incorrect: M a o <br />