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Survey & Inspection Report - C vey Form (Page 1) Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0061 Authorized Use Only Home I Reports I Help I Sign Out <br /> Hide Survey Form (Page 1): Super Stores Industries (TPID:1495368) <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 2/16/2017 1050749 <br /> electronic survey (open Documents tab) <br /> * TPID - Site Suffix: 1495368 - 01 <br /> Found in Database <br /> Super Stores Industries <br /> 16888 McKinley Ave <br /> Lathrop, CA 95330-9705 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Shane Jordan Title: Service Manager <br /> * M Tire Count: 0 <br /> Latitude: Longitude: <br /> * Inspection Type: / Routine Re-inspection Referral Observation Educational <br /> If referral, referral type: CHP CalRecycle Complaint Other <br /> Inspected By: 39-101 San Joaquin County u <br /> * Inspector: Lor Xiong <br /> * Inspection Date: 2/10/2017 <br /> * Time In 10:20 AM <br /> * Time Out 12:00 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active Passenger Generator Outdoor <br /> Closed Altered Hauler Indoor <br /> Inactive <br /> Planned Truck End-Use Container <br /> OTR <br /> Business Type: <br /> L_ New Tire Dealer ❑Auto Body Agriculture Retreader <br /> [_.. Used Tire Dealer❑ Hauler Government Crumb Rubber <br /> EJ Service Station i.�Trucking Fleet Collection Dismantler <br /> [. Auto Repair Car Dealer Shredder Tire Derived Fuel <br /> W, Other Business Type Other: Distribution Center <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=245968&0rga... 2/16/2017 <br />