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Survey & Inspection Report - °---vey Form (Page 1) Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0058 Authorized Use Only Home I Reports I Help I Sign Out <br /> EdSurvey Form (Page 1): Cemex Construction Materials Pacific, LLC (TPID:1494963) <br /> Report is in SUBMITTED status - CalRecycle approval of this inspection report is <br /> pending. <br /> Survey Submitted for CalRecycle review. <br /> Part A - Survey <br /> Create PDF from fn Email Inspection To Facility Operator 0 Inspection Form Number: IW- <br /> this Inspection Emailed on 2/3/2017 1050173 <br /> electronic survey (open Documents tab) <br /> * TPID - Site Suffix: 1494963 - 01 <br /> Found in Database <br /> Cemex Construction Materials Pacific, LLC <br /> 30350 S Tracy Blvd <br /> Tracy, CA 95377-8121 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Sok Soth Title: Fleet Mechanic <br /> * 0 Tire Count: 15 <br /> Latitude: o Longitude: <br /> * Inspection Type: / Routine Re-inspection Referral Observation' ! Educational <br /> If referral, referral type: CHP CalRecycle Complaint Other <br /> Inspected By: 39-101 San Joaquin County <br /> * Inspector: Lor Xiong <br /> * Inspection Date: 1/31/2017 <br /> * Time In 1:10 PM <br /> * Time Out 1:30 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active Passenger Generator Outdoor <br /> Closed Altered Hauler Indoor <br /> Inactive <br /> Planned q Truck End-Use Container <br /> OTR <br /> Business Type: <br /> New Tire Dealer Auto Body Agriculture ❑ Retreader <br /> Used Tire Dealer Hauler Government❑ Crumb Rubber <br /> Service Station %/ Trucking Fleet Collection ❑ Dismantler <br /> Auto Repair Car Dealer Shredder ❑Tire Derived Fuel <br /> Other Business Type Other: <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=245393&0rgani... 2/3/2017 <br />