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--------------------- ------- ------- - - <br /> HAULER OBSERVATION REPORT Observation Report Number <br /> CalRecyclests"cof"ifornia 1H-X)OCKXXX <br /> camcqde XXX(Rev <br /> DT,-CGR--YCS.4-d P--Y BLUE OR BLACK INK PEN <br /> RR it OWN It,'0 <br /> IN <br /> 9 1;r, <br /> a 1-6 <br /> 0 TPID-not availabletnot applicable <br /> Observation during,inspection at: <br /> TPID- 0 @ Generator 0 End-Use Facility 0 Other. <br /> Vehicle .1-01D=I li I q I � I 1c) I i <br /> I <br /> Plate state 0 Observation in transit <br /> Decal Observation by Inspector <br /> Number c s c, Q Tro <br /> (It Applicable) <br /> Observation Date <br /> 0 Hauler Exempt:' <br /> Hauler Name Observation Time <br /> -rovz'(�'� Tir, S P-r vi Le- rl C. AN <br /> Hauler Address FTI 0 pm <br /> Street I a 5 E i 0j; <br /> City L ok State bA z!.p Code <br /> Driver's Name D.O.B. <br /> Location of Observation <br /> e- <br /> .)�Cjnlrer b <br /> street <br /> For more informatio-n concerning Waste/Used Tire <br /> City State Zi Code <br /> !Slo c4h, C) Hauling&Manifesting,please call the Waste Tire <br /> Hotline at(866) 896-0600. <br /> Part B- <br /> 0 <br /> 0 0 PRC§42951-Waste Tire Hauler Registration and Transport of Tires 00 PRC§4295ff(6) Failure to Present.Registration to Official <br /> 0 0 PRC§42962(b)-Falsely Represents Self as Registered Hauler 0 0 14 CCR§18456A-Failure to Abide by Temporary Registration <br /> 0 0 PRC§42958(a).-Registraton/Decal in Vehicle 0 0 14 CCR 5 18459-Hauler Complying with Manifesting Requirements <br /> -0 0 PRC§42956(b)-Hauler Using an Unregistered Vehicle 0 0 Other§ <br /> Comments I Driver's Statement: <br /> -)01 <br /> 0',S�)v*cr Zsf- cz D or) <br /> T <br /> V P- <br /> Lo I) c A —si at) <br /> op ( <br /> 1'()\ -n QV 'T <br /> (,b <br /> 1-11 f 4cm A kn Q <br /> L <br /> ...... .... .. <br /> ni.R <br /> ."44�SW <br /> I nN t3,;- R Wo <br /> "We u <br /> PON% M, <br /> IVIT, <br /> Rao <br /> Correct: Incorrect: <br />