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Alikk Ah <br /> HAULER OBSERVATION REPORT <br /> Ca1Rec ele State of Califomia <br /> Y CalRecycle 775(New 2/14) <br /> D,pt fRee r—R,,y,l,,gmdRr....ry BLUE OR BLACK INK PEN <br /> Hauler Profile Observation Details <br /> 0 TPID-not available/not applicable <br /> Observation during inspection at: <br /> TPID - 1 1 8 1 2 1 1 2 6 9 <br /> Generator 0 End—Use Facility 0 Other: <br /> 0 1 <br /> Vehicle State <br /> TPID- 1 2 9 0 3 3 6 <br /> Plate 0 Observation in transit <br /> Decal Observation by Inspector <br /> Number <br /> (If Applica- 1 Xlon <br /> m 3 9 — 0 1 9 <br /> O Hauler Exempt: Observation Date <br /> O Hauler name&address not known <br /> Hauler Observation Time <br /> •AM <br /> Hauler Address 1 1 ; 4 2 0 PM <br /> 14090 <br /> Street ENFORCEMENT STATUS <br /> Alpine Rd <br /> City State Zip Code Q Notice of Violation <br /> Lodi CA 95240 <br /> Driver's Name D.O.B. Compliance Deadline <br /> Location of Observation <br /> Referred/Cal Recycle, Tire Hauler Compliance Unit <br /> Street <br /> For more information concerning Waste/Used Tire <br /> City State Zip Code Hauling & Manifesting, please call the Waste Tire <br /> Tire Load Count ❑ Hotline at(866) 896-0600. <br /> (used+waste) <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> O 0 PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> O Q PRC§42952(b)-Falsely Represents Self as Registered Hauler O O 14 CCR§18456.4—Failure to Abide by Temporary Registration <br /> O 0 PRC§42956(a)-Registration/Decal in Vehicle O O 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O 0 PRC§42956(b)-Hauler Using an Unregistered Vehicle O O Other§ <br /> Comments 1 Driver's Statement: <br /> 1.)A search done on WTMS for"Delgado Tires" TPID# 1290336 from 09/30/2015 to present resulted in 80 <br /> manifests. Most of the manifests were available on site for review during the inspection. 14 additional manifests <br /> from "Izzy's World of Tires"TPID# 1821269 were available on site for review. <br /> 2_) The 14 additional manifests reviewed were not submitted to Cal-Recycle within 90 days of the load shipment. <br /> Comment Form <br /> �(29)468-2807P h otos <br /> Driver's Signature Phone Number Inspector's Signat one Number <br /> Correct : • Incorrect: X <br />