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-1l!-NV1KUNV1.ENTAL kiFAT TH SAN JOAQUIN COUNTY Waste Tire .jurvey and Inspection Report 304E 3RD FL STOCKWEBERON CA 95202 2708 (209) 468-3420 ate of California Wh1B-54(10/03) Page_or ART A-General Inform ationlSurvey ""EA 11JSPECTIOPi I;SITE;VISfTs _ _� - - Routine Re-inspection ❑ Complaint ❑Observa�on [C,';lMB Referral ❑CHP Referral C1 other. Type(check one): ❑ Regulatory Status: Time In: Date: = 9 ry acility- -SWIS: inspected by � lw 1 Cl Permitted luded C]Exempt❑Unpermitted ile No. " ❑County/City j v T TPID: Code Time Out: Total Time: i_Operational Status f Hauler l ❑State. I-3Mctive❑Closed❑InaaU 6.0_Planned.- q } - Local: Tire Count: I Type: 3usiwn�ss/F cuity Name: �ssenger❑Altered❑Truck C1 OTR IV ` Phone: :Sto geT ",rr, address: '- d Indoor❑Container. - Ins ct r(Please Pint): �1 Business Rep: �jpIrll�44`14 Ow er: 10_7 Title: 1 _- Role of Business:.(cneekall that 3Ppy} Facility Type:(check } .:venerator (Hauler C] End-use Minor WTF(>soo tires) ❑Waste Tire Location C] Major WTF(>s,000 ares) F1 Business Type:(check all Ut tapply) uto Repair i A-to Body ❑Car Dealer ❑Collection ire Dealer ❑ Retreader ❑ Dismantler .� Trucking Fleet ❑ ShredderCrumb Rubber C er:Describe Gas Station ❑ g "' Excluded Business Types(check only H APPl( ble): _ [] 14 CCR§ 18420 (a)(3)- Facilities storing less than 500 waste tires(%Vas.e [] = premises. 14 CCR§ 18420 (a) (4) -Tire retreading facility with no more than 3,000�; s: — 14 CCR§ 18420 (a) (6)-Auto dismantler storing no more than 1,500 wasta:'==' ess than 90 days. 14 CCR§ 18420 (a)(7) 8(e) Tire dealer storing no more than 1,500 Waste ess than 90 days. uirements complete Pars B.C. It exdUded from permit.compiete Parts B and D. if not excluded from permit req �'-- PART B— Inspection of Waste Tire Dealer, Generator, Hauler and Ends V A" :C� ` :';: :1`44AULING AND MANIFESTING REQUIREMENTS Waste Tire Hauler Registration and Transport c`Tires ❑ ❑ ❑ PRC§42951 (a)- g ❑ ❑ ❑ PRC§42953-Contracts with Registered Waste Tire Haulers. ❑ ❑ [j 14 CCR§ 18459.1 (a) (b)(c)-Tire Program ID Number from ❑ ❑ p 14 CCR§ 18459.2.1 -Submittal of Manifest Forms and Tire Trip Loss =- 90 days. ❑ ❑ .❑ 14 CCR§ 18459.3 -Retention of Manifest Forms and Tire Trip Loss for 3 years. ❑ ❑ ❑ 14 CCR§ 18460.2 -Manifest System Requirements for Registered Y'laste T ire Haulers. ❑ ❑ ❑ 14 CCR§18461 -Manifest System Requirements for Waste Tire End-Use Facilities. ❑ ❑ ❑ 14 CCR§ 18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators. :f; PART C-Inspection of Waste Tire Facility p ecmita•Regjuliemenf � Site Attendant ❑(c)Access ❑ ❑ i❑� PRC§42824—Major Waste Tire Facility Permit ❑(a)Signs ❑(b) ❑ ❑ ❑ PRC§42834—Minor Waste Tire Facility Permit CW§T tt' c �_... aw�t.... ❑ ❑ ❑ PRC§42850(a)-Complies with Terms of Permit j 1 ❑ (1)Impermeable Barrier ❑ (2) ApprovedVection Plan - ❑ El C] 14 CCR§ 18420(a) -Applicable for Permit 1 ; , _f4'CCR.§17.354°;sfor"�oA' �ti►aste Tlres'o+<;ta _ ❑ ❑ ❑ 14 CCR§18423 -Filing Application for Permit77 0' `C a Storage Units 7-7 ??�; "Reeo�dkeeping Requirements-, 4 Cl(b)Fire Lanes C] LJ C] 14 CCR§18432-Operations Plan ❑ (c)Fire District Requirements Cl (d)Drainage El 11 14 CCR§18433-Emergency Response Plan ❑ (e)Slope/Grade ❑ Cl ❑ 14 CCR§18447-Records Available ❑(f)Siting(New Facilities) 14 CCR.§17351 ?Fire'Preventfon Measures ❑ (g)Rim Removal ❑(h)Protection from Pyrolytic Oil Runoff ❑ (a)Communication Equipment ;_��M ❑ (b)Fire Equipment [ [ [ 14 CCR§17356 -Indoor Storage ❑ (c)Water Supply =a'ihty compliance with NFPA 231D-1989 ❑ (d)Other Requirernents