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Survey & Inspection Report - r-•-vey Form (Page 1) Page 2 of 2 Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility Part B - Inspection of Waste Tire Dealer, Generator, Hauler, and End-Use Facility V A HAULING AND MANIFEST REQUIREMENTS ❑ ❑ PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires ❑ ❑ PRC § 42953 - Contracts with Registered Waste Tire Haulers ❑ ❑ PRC § 42956 - Hauler Registration/Decal in Vehicle ❑ ❑ 14 CCR § 18459 - Responsible Entities Complying with Manifesting Requirements ❑ ❑ 114 CCR § 18459.1 -Tire Program ID Number and Certificate from CalRecycle ❑ ❑ 14 CCR § 18459.2.1 - Submittal of Manifest Forms and Tire Trip Logs within 90 days ❑ ❑ 14 CCR § 18459.3 - Retention of Manifest Forms and Tire Trip Logs for 3 years ❑ ❑ 14 CCR § 18460.2 - Manifest System Requirements for Registered Waste Tire Haulers ❑ ❑ 14 CCR § 18461 - Manifest System Requirements for Waste Tire End-Use Facilities ❑ ❑ 14 CCR § 18462 - Manifest System Requirements for Waste Tire Generators ❑ ❑ Other 14 CCR § ENFORCEMENT STATUS Notice of Violation OExtension Compliance Deadline: (Required for NOV or EXT) OReferred / CalRecycle Enforcement DIn Compliance - No Violations Comments: L A J Paragraph Font Family Font Sizes L_ Routine waste tire inspection conducted on this date and the following was noted: No violations or areas of concern. Notes: v Signatures ❑ Inspector's Signature❑ Business Rep's Signature Upload Inspection Survey PDF Browse... Created by: Harprit Mattu 7/25/2016 4:13 PM Last Updated by: Harprit Mattu 7/25/2016 4:14 PM Waste Tire Management System httos://secure.caIrecycle.ca.gov/WTMS/ Contact: WasteTires(a)cal recycle.ca.gov 1-866-896-0600 (toll free) https:Hsecure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=236174&Orga... 7/25/2016