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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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33 (STATE ROUTE 33)
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30131
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4700 - Waste Tire Program
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PR0526106
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COMPLIANCE INFO
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Entry Properties
Last modified
11/20/2024 8:59:26 AM
Creation date
12/30/2019 2:24:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0526106
PE
4740
FACILITY_ID
FA0013628
FACILITY_NAME
GREEN VALLEY TRANSPORTATION
STREET_NUMBER
30131
Direction
S
STREET_NAME
STATE ROUTE 33
City
TRACY
Zip
95376
APN
25502051
CURRENT_STATUS
02
SITE_LOCATION
30131 S HWY 33
QC Status
Approved
Scanner
CField
Tags
EHD - Public
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(7354040UgL <br /> Waste Tire Survey & Inspection Report Inspection_ReportNumbe�� <br /> stateorca°t°`n'a Survey Form - Page 1 13 - 1 0 7 3-4 9 2 1 <br /> st t tet(New Oae<) <br /> Calltomla Integrated Waste Management 6oartl - <br /> Part A-Survey BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- �/ Inspection Type (Fill one) <br /> Site Suffix: 7 I J. S y i_/ �_ L_ _/_ ®Routine Q Re-inspection Q Referral Q Observation <br /> Local I if Referral,choose referral type(Fill one) <br /> Identifier: c CHP 0 CIWMB 0 Complaint 0 Educational Visit 0 Other <br /> Business or Facility Name <br /> Inspected By Inspector <br /> Physical Address` v fr��� �J 1{ r <br /> Inspection Date I I / S <br /> 6`[ 0 1 -- I ---I-- <br /> � � rf'�:;: �' Time In __ Time Out <br /> Business Rep Title AM ) Q AM <br /> PM ®PM <br /> ob woo 1 S� <br /> J3.6Operational Status Tire Type Business Rote Storage Type <br /> Tire Count(Whole/PTE) 6 (Fill one only) (Fill all that apply) (Fill all that apply) (Fill all that apply) <br /> r ®Active Q Passenger *Generator ®Outdoor <br /> O Q Closed Q Altered <br /> GPS Latitude Q Hauler Q Indoor <br /> D Q Inactive 4D Truck <br /> Longitude — Q Planned Q OTR Q End-Use Q Container <br /> Business Type (Fill all that apply) <br /> Q New Tire Dealer Q Auto Repair IS Trucking Fleet Q Government Q Retreader 0 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 Q Other I <br /> Part B-Inspection of Waste Tire Dealer,Generator,Hauler and End-Use Facility ENFORCEMENT STATUS <br /> V A HAULING AND MANIFEST REQUIREMENTS Q Notice Of Violation Q Extension <br /> Q Q PRC§42951-Waste Tire Hauler Registration and Transport of Tires <br /> Q Q PRC§42953-Contracts with Registered Waste Tire Haulers. Compliance Deadline <br /> PRC§42956-Registration/Decal in Vehicle <br /> Q Q 14 CCR§18459 -Responsible Entities Complying with Manifesting Requirements Date m / m / m <br /> Q Q 14 CCR§18459.1-Tire Program ID Number from CIWMB <br /> Q Q 14 CCR§18459.2.1-Submittal of Comprehensive Trip Logs within 90 days (Required for NOV or EXT) <br /> Q O 14 CCR§18459.3-Retention of Comprehensive Trip Logs for 3 years <br /> Q Q 14 CCR§18460.2-Manifest System Requirements for Registered Waste Tire Haulers Q Referred/CIWMB Enforcement <br /> O O 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 Compliance'- No Violations <br /> Q 1 Q 1 Other: § <br /> Comments <br /> t�+l nt+ inS. �crr tst,=Hna'-C dQ�W,_s— r <br /> Rapes ty.t�tz y <br /> tN��---- <br /> 7ft_s—ah i cr/c �V-aIdalcul��a4s�-- <br /> linspection Form Included:Q y <br /> Comments Included:Q / — 41.6c—0 Z 3 <br /> Business Reps Mgha(ure___YL Phone Number Inspector's Signature Phone Number <br /> n( <br /> INSTRUCTIONS ON BACK Correct: Incorrect: VU 11E�XIA�MIPILIE1 1112n3 62081 <br /> zX <br /> ■ White Copy.CIWMB Yellow Copy.Operator Pink Copy:LEA ® ■ <br />
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