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w • 1 Waste Tire Manifest System Field Reference Guide Comprehensive Trip Log Instructions (Completed by the HA ULER) 2 1., Enter hauler's decal number,vehicle license G Compro eris ve rip og andl 000 pts -►, ..». plate number,and state of issuance. EXAM► IMIRP 2.. Print hauler's business name address and INSTRUCTIONS ON BACK il,':; > > '�'='"` =�% �w c-«•"`»=N" r =��.: ''""`- phone number(including area code).If a business stamp or label is used, it must be 3-- Atl.ygg. applied on all copies of the CTL form. .... �' � r L.,Iv.Ga: and Lp J h,, x-ter =_, .� -•�n.x.,�r..., 3. The hauler/driver prints name,signs,and ..x •--•^ 'tea= =-•„• dates top portion of the CTL form when completing the first receipt on the form. x3a5s -- lj[JUUUUU-IJLJ 4. Enter Hauler's TPID number(including site Pr•9irin 0 elt.e"lx Fatn191YT�4p11.M"'. suffix)on CTL receipt and hauler's phone k a a -as a a a a o number(including area code). 4 , .:. r ,x u..,•c. J 1.171-A 5. Check the appropriate box to indicate if this - -.... _ N•uNr T•bph•m Mum6w ;y „ ,I transaction is a waste tire pickup or delivery, enter the load date(use the mm/dd/yy format), check the box for the appropriate load type, and enter the load amount. S I' �_' TIn Program 6. Enter the TPID number for the generator or Fend use facility location.Print generator or end 11_ °+;;.f nN••'4WIp1F use facility business name,address,and 6," "'""•`''''""°"`""in°" "`'`"""" phone number.If a business stamp or label is J used,it must be applied on all copies of the CTL form. 7- A ;,; T 7. After the hauler completes the CTL receipt, W-W Tln Pr"9-1O S"•SAU "• the generator or end use facility representative -- oa o� oaoa will place their initials in the box provided Ir: 1 I 1_{. I__�L__Ix.. °• indicating that they have reviewed the Na"NrT.lap^•n•"umDfr Sl,r, ^,I,� information provided by the hauler and that - such information is true and correct. Know Your Responsibility! For More Information GENERATORS—If generators dispose of 10 or more waste tires outside of the business location,they are required to use Hotline(toll-free): 1-866-896-0600 a registered waste tire hauler and obtain a Tire Program Website: www.ciwmb.ca.gov/Tires/ Identification(TPID)number.A copy of the Comprehensive Trip Log(CTL)receipt will be retained at the place of E-mail: WasteTiresaxiwmb.ca.f ov business for three years. Mailing address • HAULERS—You are required to complete the entire California Integrated Waste Management Comprehensive Trip Log,,obtain the initials of the operator, Board and submit a copy of the CTL form to the CIWMB within 14 Waste Tire Hauler Program(MS-22) days.A copy of the CTL form will be retained at the place of P.O.Box 4025 business for three years. Sacramento,CA 95812-4025 END USE FACILITY—Is required to obtain a TPID number and retain a copy of the CTL receipt at their place of business for three years.They may accept tires from an unregistered hauler transporting 10 or more tires or may accept tires from a registered hauler with no CTL receipt,but in both cases,the Publication#623-05-004 end use facility operator will complete an Unregistered Hauler Zero Waste California &Comprehensive Trip Log Substitution form.Unregistered Copyright 2005 by the California haulers transporting fewer than 10 waste tires are not ■ M d re i req u " MEN Integrated Waste Management Board. to comply with the waste tire hauler registration or CTL �... All rights reserved.This publication, P Y g lxr•u"a•run ' requirements. rA„x or parts thereof,may not be xAxauewex•r MOARn reproduced.without permission.