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Survey & Inspection Report irey Form (Page 1) 0 Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0057 Authorized Use Only - I Reports I Help I Sign Out <br /> Hide Survey Form (Page 1):Safeway(TPID:1287141) <br /> Report is in SUBMITTED status - CalRecycle approval of this inspection report is <br /> pending. <br /> Survey Submitted for CalRecycle review. <br /> Part A -Survey <br /> Create PDF from Email Inspection To Facility Operator M Inspection Form Number: IW- <br /> this Inspection Emailed on 12/27/2016 1048524 <br /> electronic survey (open Documents tab) <br /> * TPID - Site Suffix: 1287141 - 01 <br /> Found in Database <br /> Safeway <br /> 16900 W Schulte Rd <br /> Tracy, CA 95377-8985 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Kyle Buurkarl Title: Technician <br /> * R1 Tire Count:47 <br /> Latitude: o Longitude: o <br /> * Inspection Type:Q Routine❑ Re-inspection❑ Referral ❑Observation 01 Educational <br /> If referral, referral type:❑ CHP❑ CalRecycle ❑ Complaint ❑Other <br /> Inspected By: 39-10.1 San Joaquin County u <br /> * Inspector•I Ben Escotto u <br /> * Inspection Date: 12/19/2016 <br /> * Time In 1 11:25 AM <br /> * Time Out 12:35 PM <br /> �* Operation Status Tire Type Business Role Storage Type <br /> - <br /> ❑Active ❑Passenger Generator [] Outdoor <br /> Closed 0 Altered <br /> 8 Inactive (�Haulers; Indoor <br /> Planned ❑Truck ❑End-Use ❑ Container <br /> ❑OTR <br /> Business Type: <br /> ❑ New Tire Dealer ❑Auto Body ❑Agriculture ❑ Retreader <br /> ❑Used Tire Dealer❑ Hauler ❑Government❑Crumb Rubber <br /> ❑Service Station P/1 Trucking Fleet❑Collection ❑ Dismantler <br /> ❑Auto Repair ❑Car Dealer ❑Shredder ❑Tire Derived Fuel <br /> Rl Other Business Type Other: Warehouse/Distribution Center <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=243743&0rg... 12/27/2016 <br />