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O; aV I(y_ p <br />San Joaquin County <br />2. ,Z <br />e: <br />iS <br />Environmental Health Department <br />304 E. Weber AN enue, third floor <br />Stockton, CA 95202 2708 <br />Phone: (209) 468 3120 <br />c44.iFoR'` <br />Fax: (209) 464 Oli8 <br />File Number <br />In ectio ate Time In <br />ompa y Name <br />pector Signature�� <br />Waste Tire Generator <br />official Survey and <br />Inspection Report <br />T,X, Out Ir,sp tion Time <br />Also Present <br />Page 1 of <br />PART A - S e <br />X I Exclusion Criteria <br />14 CCR 6 18420 (1)(11 Was .fires stgred!disnosPd at a snlid waste dison-sal fadlity oermitted nursuant to Title 14. <br />14 CCR 6 1 P,420 (al(21 Agricultural ou,: eses' less than 5 000 waste tires and rendered incanable of hnldinn accumulations of water. <br />14 CCR 6 18420 (x1(31 Facility St";" !ess than Soo waste tires. <br />14 CCR 6 18420 (a)(41 Tire treading *a :';` with ng mere than 3.000 waste tires on premises. <br />6 18420 (11(61 Autn dismantler storing nn more than 1.500 waste tires for less than 90 days. <br />14 CCR <br />SC 14 CCR 6 18420 IgNM Tire. dealer stg na no more than 1 500 waste tires for less than 90 days. <br />14 CCR 6 18420 (el l lsed fire dearer is in rnmoliance with 14 CCR 17225 820 and has fewer than 1500 waste tires in accordance with PRC 42A08(cl. <br />j Registration #: Phone #: <br />h <br />ul am Address: 1 <br />PART B — Inspection <br />The standards referenced ce:cA a2 corsidered in compliance unless make--' with one of the following: V=violation; A=area of concern; <br />PRC=Pubilc Resources Code. 14 CCR=�._e 14 of Laurornia �,ouc u, ,cyu ouv,, reverse for description of applicable of laws and regwauons. <br />COMMENTS: <br />,lb, to �16 z,-, 7� - P, <br />White Copy: LEA Carbon Copy: Operator <br />