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TPID -Inspection <br />U <br />INSTRUCTIONS ON BACK Correct:. <br />O Service <br />Station O Hauler O Agriculture O Shredder O Other <br />62081 <br />Part B - Inspection of Waste Tire Dealer,G enerator, Hauler and End -Use Facility <br />■ <br />ENFORCEMENT STATUS <br />Type (Fill one) <br />A, <br />HAULING AND MANIFEST REQUIREMENTS <br />Site Suffix: <br />.1 <br />O <br />O <br />PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires <br />O O <br />O Routine O Re -inspection O Referral <br />If Referral, choose referral type (Fill one) <br />O Observation <br />Local <br />O O <br />PRC § 42956 - Registration/Decal in Vehicle <br />Identifier: <br />O CHP O CIWMB O Complaint O Educational Visit O Other <br />Business or Facility Name <br />Inspected By <br />Inspector <br />c <br />O <br />7/--T,;,/ <br />14 CCR § 18459 - Responsible Entities Complying with Manifesting Requirements <br />Physical Address <br />0 <br />/-m <br />Inspection Date <br />J / <br />FT -sl - <br />m <br />Street <br />useca i ue ucdroi U r ULU DUUY lJ — -01-1 U ... .,...... v ........... . .......... <br />INSTRUCTIONS ON BACK Correct:. <br />O Service <br />Station O Hauler O Agriculture O Shredder O Other <br />62081 <br />Part B - Inspection of Waste Tire Dealer,G enerator, Hauler and End -Use Facility <br />■ <br />ENFORCEMENT STATUS <br />V <br />A, <br />HAULING AND MANIFEST REQUIREMENTS <br />® <br />O Notice Of Violation Q Extension <br />O <br />O <br />PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires <br />O O <br />PRC § 42953 - Contracts with Registered Waste Tire Haulers. <br />Compliance Deadline <br />O O <br />PRC § 42956 - Registration/Decal in Vehicle <br />O <br />O <br />14 CCR § 18459 - Responsible Entities Complying with Manifesting Requirements <br />Date <br />0 <br />/-m <br />/ <br />m <br />O <br />O <br />14 CCR § 18459.1 - Tire Program ID Number from CIWMB <br />O O <br />14 CCR § 18459.2.1 - Submittal of Comprehensive Trip Logs within 90 days <br />(Required for NOV or EXT) <br />14 CCR § 18459.3 - Retention of Comprehensive Trip Logs for 3 years <br />O <br />O <br />14 CCR § 18460.2 - Manifest System Requirements for Registered Waste Tire Haulers <br />0 Referred f CIWMB Enforcement <br />0 <br />0 <br />14 CCR § 18461 - Manifest System Requirements for Waste Tire End -Use Facilities <br />O O <br />14 CCR § 18462 - Manifest System Requirements for Tire Dealers or Waste Tire Generators <br />(4 In Compliance - No .Violations <br />O O <br />(Other: § <br />— -; <br />Comments <br />Ph^n. Idiimh <br />INSTRUCTIONS ON BACK Correct:. <br />Incorrect: 'x <br />.hh ' � <br />62081 <br />■ <br />White Copy: CIWMB <br />Yellow Copy: Operator <br />Pink Copy: LEA <br />® <br />■ <br />