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.............. <br /> HAULER OBSERVATION REPORT <br /> CalRecycle CalR��e'i75(New2/14) <br /> DkTL d Resources Recycling and Recovery BLUE OR BLACK INK PEN <br /> Hauler Profile Observation Details <br /> O TPID-not available/not applicable Observation during inspection at: <br /> TPID- <br /> 3 y Z D — o Generator O End—Use Facility 0 Other: <br /> Vehicle TPID- 6 5 O 6 _ O <br /> Plate State Q Observation in transit <br /> Decal Observation by Inspector <br /> NumberfV�J�TT <br /> (If Applica- <br /> O Hauler Exempt: Observation Date <br /> Q Hauler name&address not known 1 <br /> Hauler Observation Time <br /> � 5 ° AM <br /> Hauler Address of <br /> 2033 Rwrciir�r N\ae_ <br /> Street ENFORCEMENT STATUS <br /> Cit��c Cl— CA g45y5 Zip Code 0 Notice of Violation <br /> Compliance Deadline <br /> Driver's Name D.O.B. <br /> Location of Observation <br /> 7.216 N• Way � Referred/CalRecycle, Tire Hauler Compliance Unit <br /> Street r <br /> s� N.ov% CX gS2b5 For more information concerning Waste/Used Tire <br /> City State Zip Code Hauling&Manifesting, please call the Waste Tire <br /> Tire Load CountElHotline at(866) 896-0600. <br /> (used+waste) I <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> O O PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> O O PRC§42952(b)-Falsely Represents Self as Registered Hauler O O 14 CCR§18456.4–Failure to Abide by Temporary Registration <br /> O O PRC§42956(a)-Registration/Decal in Vehicle r O 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O O PRC§42956(b)-Hauler Using an Unregistered Vehicle Q O Other§ <br /> Comments/Driver's Statement: <br /> ,. _ .�_ca. . , ._�c�����o��'�i�___ <br /> � k. off.��,� ,,.�. ss "g am . <br /> Mo <br /> -' <br /> ,mac �• N we� s .,e <br /> sow— c,,._LAve�P—T`v�- <br /> 'C1�e.��,k�...�\- - c�o_c�.�t�a��S--Css'e_=_ca,����:c ,-�—�3--Ce�Q_ac_�'$.��`•.x,e-�5—_ <br /> --Amo--.T:ce=p'_.c _`���v� � <br /> _ .�_. . �.a ks_._._c�—�-xaC�ccc�_.r✓�4s- e�.�,._T_S-__�-'�..�_6.__.__.__.---C--Ra -�Cx,�_, <br /> Comment Form o <br /> Photos Driver's Signature Phone Number Ins ector's tignature Phone Number �1 <br /> Correct : Incorrect: W Q) <br />