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�' " ��z; + St. .Ylre S.0 . ey: Iflsp.adtioh: e0ort ;,Inspection Report Number
<br /> r 51:918 orcarlfwQP2
<br /> Ganforni$InLegralad WaslAa agamern aard Survey-For 'r. Pa i.' 1 1i f �i_V 161( :
<br /> •
<br /> F! "Surae SLUE OR BLACK INk PEN .
<br /> rpiD- ,.., fE Instidaaop Type (Fill.one)
<br /> : r rite Suffl '. .�•.: -� � �. __
<br /> 6.�„:.,;.. �. �.Raut7rie'•• �R�Iri'�psct;on [�'Re�rral ':(�otiservaHOri;
<br /> lOaai:_.-.,• if�efarF-A;e)haoe rf��f^yp �lrrl[o�o�— — ---
<br /> IdentiPger: '{'. � �U r i:a z�rV SNP Q-C.N4 . 0 C'ompla nt 0 E ri VI '0
<br /> 1 dura o al' alt oi► r"
<br /> Businea9 or Facility Hama In aGtsd B
<br /> i v Inspector•
<br /> 1GaN Addroess'
<br /> �''� '• - . - 1. �`�'�:�� f'.�r?� �.J• ,
<br /> SIMI
<br />' . , - -� •, ��'�•� Inspectivn Date-� �� ��. ����,..�! � �._-_J-_� •
<br /> ., Fare_717�oo Time in Time out.
<br /> Business Rep:. Tlt1e — -— tr1 _ - -_ ,,r — -11 AM
<br /> ,operational Status Res
<br /> ��. ine�Role ..
<br /> (Fill one only) (Fill all!hat apply)
<br /> V u � Generator. -
<br /> CiPS Latitude'
<br /> ` x•
<br /> Hauler.
<br /> inactiva
<br /> L.ongitud� Er1+�-4Jse.
<br /> RX
<br /> ~;.. r':'• "+�; �;.;r..x a c�.c� -
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<br /> 1 x+•, ,. -
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<br /> ° W N4wTire Dealer Q AU to Rapair••'t).Trucking Fleet� 0 Gavemmmt :0 Reiraader �0 Dismantler. I�Tire Derived Fuel
<br /> Used`lire Dealer 0 Auto Body- �Gar Dealer• 0 �IleOon c]Crumb Rubber
<br /> 0 ge-Are 5taiion Hauler Q•A�rlculture 0 Shredder Other
<br /> -....... r'
<br /> Pad#)3 -Inspdotion of Waste Tire.Dealer, G�nerator,,14auler, and End-USe FsCility ENFORCEM' kf 7ATU5 :-
<br /> V •JA HAIJLX1dG ANa MANIFEST 1FQUtREM�NTB - r
<br /> O 0 PRC§42951 -WaM-71`re.Hauler Registration and TrgUporf of Tires
<br /> 0,RPlJcaV Violation • �6rtaq`s3Ore.- '
<br /> C) -PR.0§;42953-Corrfrac' with RegisX'ed Waste Tire Haulers. Cornpilar�aA Daailplla.
<br /> ( • • PRC§42956'-Regtsiratian[Decai in Vehicle
<br /> t4'CCR'§18456 -Responsible EnVUes Complying with Manifesting Re'qulraments.- 15abe
<br /> C) 14 CCR§18459:1.:Tire Priam 14 NuCnber frau CIWM13
<br /> 0. •14 CCR'§1$4559.2.1 -Submittal'afComprehensiw$Trip-Logs within 9l7 days �� ed€�N�VvXEXTJ
<br /> C)• 0' 14 CCR§1B459.3-Rf;lerdion a£Qamprehensive Trip Logs Fora years
<br /> Q Q '14.MR§18460.2-Manifest System Requirsma~ tsfor Registered Waste•Tire'Haulers O'R�ar'tvaa7'O l-MID 'EnfoTGement
<br /> 14 CCR,§1840 -Manifest"tRm Requlr'9ments for-Waste.Tire End-Us$F$aIIltles
<br /> 14 GCR§18462•-.MariifestSystsrn Requirements Deel&&orVVast6Tire Gonaratgi's CompUanc + Na'Vlol ons
<br /> Other: §
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