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EHD Program Facility Records by Street Name
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5151
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4700 - Waste Tire Program
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PR0526101
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COMPLIANCE INFO
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Entry Properties
Last modified
5/10/2019 1:48:23 PM
Creation date
5/10/2019 10:05:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0526101
PE
4740
FACILITY_ID
FA0014894
FACILITY_NAME
SIMPSON STRONG-TIE CO
STREET_NUMBER
5151
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
Way
City
Stockton
Zip
95206
APN
17746023
CURRENT_STATUS
02
SITE_LOCATION
5151 S Airport Way
QC Status
Approved
Scanner
CField
Tags
EHD - Public
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09136040027 <br /> iiiiiij Waste Tire .Survey & Inspection Report Inspection Report Number <br /> State LE ClWM of California Survey Form - Page 1 f 9 1 0 0 8 7 2 <br /> CIWM8181(New 04/04) ' <br /> California Integrated Waste Management Board <br /> Part A-Survey BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> T - �Aj O _ O / Inspection Type (Fill one) <br /> Siteite Suffix: Routine QRe-ins Re-inspection <br /> Q Referral Q Observation <br /> Local If Referral,choose referral type(Fill one) <br /> Identifier: �, Q CHP Q CIWMB Q Complaint Q Educational Visit Q Other <br /> Busine s or Facility.Name - <br /> I �yj I Inspected By Inspector <br /> jzon e <br /> Physical Address <br /> Street <br /> ( S/_ i/ ���� I Inspection Date <br /> City �`9 roman State ZIP Code Time In Time Out <br /> Business Rep Title O AM Q AM <br /> e� 1E� O PM m ' � QPM <br /> IL/_ �XA V I_ �✓ <br /> ," Operational Status Tire Type Business Role Storage Type <br /> Tire Count(Whole/PTE) I (Fill one only) (Fill all that apply) (Fill all that apply) (Fill all that apply) <br /> Q Active Q Passenger Q Generator Q Outdoor <br /> O Q Closed Q Altered <br /> GPS Latitude � , � Q Hauler Q Indoor <br /> O ® Inactive Q Truck <br /> Longitude [71 <br /> Q Planned Q OTR Q End-Use Q Container <br /> Business Type (Fill all that apply) <br /> (D-New Tire Dealer Q Auto Repair Q Trucking Fleet Q Government Q Retreader Q Dismantler Q Tire Derived Fuel <br /> Q Used Tire Dealer Q Auto Body Q Car Dealer Q Collection Q Crumb Rubber <br /> Q Service Station Q Hauler Q Agriculture Q Shredder 40 Other <br /> Part B-Inspection of Waste Tire Dealer, Generator, Hauler and End-Use Facility ENFORCEMENT STATUS <br /> U A ,HAULING AND MANIFEST REQUIREMENTS Notice Of lfiolation <br /> Q Q PRC§42951 -Waste Tire Hauler Registration and Transport of Tires Q Q Extension <br /> Q Q PRC§42953-Contracts with Registered Waste Tire Haulers. Compliance ne dline <br /> Q Q PRC§42956-Registration/Decal in Vehicle <br /> Q Q 14 CCR§18459 -Responsible.Entities Complying with.Manifesting Requirements Date <br /> Q Q 14 CCR§18459.1 (a)(b)(c)-Tire Program ID Number from CIWMB <br /> Q Q 14 CCR§ 18459:2.1 -Submittal of Manifest Forms and Tire Trip Logs within 90 days (Required for NOV or EXE <br /> 14 CCR§18459.3-Retention of Manifest Forms and Tire Trip Logs for 3 years <br /> Q Q 14 CCR§18460.2-Manifest System Requirements for Registered Waste Tire Haulers Q Referred I CIWMB Enforcement <br /> Q Q 14 CCR§18461 -Manifest System Requirements for Waste.Tire End-Use Facilities <br /> Q Q 14 CCR§ 18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators ® In Compl100112111INo Violations <br /> Q Q Other: § <br /> Comments �aCi moi- lze4� _44 d*W 4,1 y-1_a- L�/„- / ✓ 1,-d 4--y <br /> �—Ar"r . (:79- ,r.-� V4-a, 9 4je11Zr/1V,"t 7�r� <br /> Inspection Form Included: Q r 29g <br /> Comments Included: -- /' `�����Z��L�7/s,' Y/9-0732 <br /> usi ep's (gnat Phone Number Inspector's Signature Phone Number <br /> INSTRUCTIONS ON BACK Correct: Incorrect: 62os1 <br /> � Xflh►IP '� E ' � I23 <br /> ■ White Copy:CIWMB Yellow Copy.Operator Pink Copy:LEA ® S <br />
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