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Survey & Inspection Report -4vey Form (Page 1) Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0062 Authorized Use Only Home I Reports I Help I Sign Out <br /> Hide Survey Form (Page 1): Raley's#356 (TPID:1831501) <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 this n Email Inspection To Facility Operator [E Inspection Form Number: IW-1051652 <br /> electronic survey <br /> * TPID - Site Suffix: 1831501 - 01 <br /> Found in Database <br /> Raley's #356 <br /> 4219 E Morada Ln <br /> Stockton, CA 95212 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Katrina Filppula Title: Clerk <br /> * D Tire Count: 0 <br /> Latitude: o 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 u <br /> * Inspection Date: 3/2/2017 <br /> * Time In 1.00 PM <br /> * Time Out 1:15 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active [_j Passenger Generator Outdoor <br /> Closed <br /> Inactive ❑Altered Hauler Indoor <br /> Planned ❑Truck End-Use Container <br /> ❑OTR <br /> Business Type: <br /> New Tire Dealer f]Auto Body Agriculture Retreader <br /> Used Tire Dealer _] Hauler Government Crumb Rubber <br /> Service Station _]Trucking Fleet Collection Dismantler <br /> ['Auto Repair _l Car Dealer Shredder Tire Derived Fuel <br /> Other Business Type Other: Gas Station/Car Wash <br /> Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=246870&0rgani... 3/7/2017 <br />