My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
E
>
ESCALON BELLOTA
>
6250
>
4700 - Waste Tire Program
>
PR0526540
>
COMPLIANCE INFO
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
4/3/2020 3:11:32 PM
Creation date
4/3/2020 1:58:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0526540
PE
4740
FACILITY_ID
FA0004502
FACILITY_NAME
NORMANS NURSERY
STREET_NUMBER
6250
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
LINDEN
Zip
95236
APN
09317009
CURRENT_STATUS
02
SITE_LOCATION
6250 ESCALON BELLOTA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
CField
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
21
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
r - <br /> ® r• Ins ection Report Number Waste Tire Su ,y & Inspection Rep®ri £__..p._ _ p � <br /> • State of California T i — <br /> p� CIWMB 181(New 04/04) Survey Form - Page 1 111086985 <br /> California Integrated Waste Management Board --- --- -- - - <br /> Part A- Survey _- <br /> BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- ) Inspection Type (Fill one) <br /> Site Suffix. Q Routine Q Re-inspection Q Referral Q Observation <br /> Local ') If Referral,choose referral type(Fill one) <br /> Identifier: _ .f'•'' ( (F %�: "� s Q CHP Q CIWMB Q Complaint Q Educational Visit Q Other <br /> Business or Facility Name /i Inspected By Inspector <br /> Physical Address L 'Gn <br /> sh eelr i } <br /> r I Inspection Date <br /> B Li <br /> l <br /> i ` <br /> T t Time In Time Out <br /> ta.; Z/('Cor,,; .., �_ <br /> Business Rep Title S O AM <br /> 0 PM <br /> ) (FiStora e Tye(peStatus ( eayp <br /> (Fill ononly) FlI that apply ( ll all that apply) (Fill all that apply) <br /> Q Active Q Passenger Q Generator Q Outdoor <br /> CW Q Closed Q Altered <br /> C7PS Latitude EI-1 <br /> ', Q Hauler Q Indoor <br /> Q Inactive Q Truck <br /> Longitude — 7_777 0 Q Planned Q OTR Q End-Use Q Container <br /> Business'-Type (Fill all that apply) <br /> Q New Tire Dealer Q Auto Repair Q Trucking Fleet Q Government Q Retreader Q 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 <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 /> Q Q 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 Q 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 /> Q Q 14 CCR§18461 -Manifest System Requirements for Waste Tire End-Use Facilities - - - <br /> Q I Q 14 CCR§18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators Q In Compliance - No Violations <br /> Q O (Other: <br /> Comments 1..ti ( I i \ <br /> 1: <br /> Inspection Form Included: Q' <br /> Comments Included: - - <br /> Q'Business Rep's Signature Phone Number Inspector's Signature Phone Nuniper <br /> 62081 - <br /> INSTRUCTIONS ON BACK Correct:0 Incorrect: �' �: � ��„ ���A JWii� �� <br /> EWhite Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ® ■ <br />
The URL can be used to link to this page
Your browser does not support the video tag.