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Survey & Inspection Report*rvey Form(Page 1) 0 Page 2 of 3 Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility Part B - Inspection of Waste Tire Dealer, Generator, Hauler, and End-Use Facility V A HAULING AND MANIFEST REQUIREMENTS ❑ ❑ PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires ❑ ❑ PRC § 42953 - Contracts with Registered Waste Tire Haulers ❑ ❑ PRC § 42956 - Hauler Registration/Decal in Vehicle ❑ ❑ 14 CCR § 18459 - Responsible Entities Complying with Manifesting Requirements ❑ ❑ 114 CCR § 18459.1 - Tire Program ID Number and Certificate from CalRecycle ❑ ❑ 14 CCR § 18459.2.1 - Submittal of Manifest Forms and Tire Trip Logs within 90 days ❑ ❑ 14 CCR § 18459.3 - Retention of Manifest Forms and Tire Trip Logs for 3 years ❑ ❑ 14 CCR § 18460.2 - Manifest System Requirements for Registered Waste Tire Haulers ❑ ❑ 14 CCR § 18461 - Manifest System Requirements for Waste Tire End-Use Facilities ❑ ❑ 14 CCR § 18462 - Manifest System Requirements for Waste Tire Generators ❑ ❑ Other 14 CCR § ENFORCEMENT STATUS ONotice of Violation)Extension Compliance Deadline: im (Required for NOV or EXT) )Referred / CalRecycle Enforcement *In Compliance - No Violations Comments: l ft ;[ A - A (Paragraph w Font Family - Font Sizes Routine waste tire inspection done on this date and the following was noted: No violations or areas of concern. Notes: 1.) Permission to conduct inspection was granted by David Patterson (Yard Foreman). 2.)TPID certificate is posted in the office. 3.) No activity observed on WTMS. Signatures ❑Inspector's Signature �:] Business Rep's Signature Upload Inspection Survey PDF { Browse... Administrative Notes Message for CalRecycle: https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=243 519&Org... 12/15/2016