Laserfiche WebLink
Inspection Report Number <br /> Waste Tire survey & Inspection Repo <br /> P�1 state of calHornis(n11 - 1210521 <br /> CatRecyclet9tev.lalol survey Form - Page 1 <br /> Dep" <br /> of Rema Recycling and Recovery(CalRry <br /> ecle) BLUE OR BLACK INK PEN <br /> Part A-Survey <br /> Business Profile Inspection Details <br /> TPID- - Inspection Type(Fill one) <br /> Site Suffix.- 1 5 1 „t ) t O Routine Re-inspection 0 Referral 0 Observation <br /> LocalS(^_ �C.�`i� _w � If Referral,choose referral type Fill one) <br /> IdentIdentifier.Identifier. wx `�� �� V4 O CHP 0 Capacycie 0 Complaint 0 Educational Visit 0 Other <br /> Business or Facility Name Inspected By Inspector <br /> '?4A� -�rv�e� l t�e�� LP 31 - lot _AY��CSL/4 <br /> Physical Address <br /> V Inspection Date Q / 06 I 13 <br /> CA (- Time in ` Time Out <br /> 0 AM Q AM <br /> Title <br /> Business Rep `- _ p2 • J� !PM 5 • 3 d 49 PM <br /> Lia r`�P�G�GIi>� <br /> operational Status Tirelype':.'.'_ ' Business.Role ator Mile <br /> Tire Count(Whole/PTE) (Fill one only) (FII all that apply) FRIT all that apply) (Fill all that apply) <br /> 9 0 Active Passenger 0 Generator 0 Outdoor <br /> GPS <br /> Latitude closed O!► ,; ., 0 Hauler 0 Indoor <br /> 0 0 Inactive 0`Th ifctt "1' <br /> Longitude - 0 Planned O OTR O End-Use 0 container <br /> Business Type(Fill all that apply) <br /> 0 New Tire Dealer 0 Auto Repair 0 Trucking Fleet 0 Govemment 0 Retreader O Dismantler 0 Tire Derived Fuel <br /> 0 Used Tire Dealer 0 Auto Body 0 Car Dealer 0 Collection O Crumb Rubber <br /> Ole- Trrrre E irr,n-� <br /> 0 Service Station O Hauler O Agriculture O Shredder O Other ��j � {s <br /> Part B- Inspection of Waste Tire Dealer,Generator, Hauler and End-Use Facility ENFORCEMENT STATUS <br /> V A HAULING AND MANIFEST REQUIREMENTS <br /> 0 Notice Of Violation Q Extension <br /> O O <br /> PRC§42951 -Waste Tire Hauler Registration and Transport of Tires <br /> 0 0 PRG§42953-Contracts with Registered Waste Tire Haulers. Compliance Deadline <br /> PRC§42956-RegistratiordDecal in Vehicle <br /> 0 O 14 CCR§18459-Responsible Entitles Complying with Manifesting Requirements Date m I m / m <br /> 0 0 14 CCR§18459.1 -Tire Program ID Number from CalRecycle <br /> O O 14 CCR§18459.2.1 -Submittal of Comprehensive Trip Logs within 90 days (Required for NOV or EV) <br /> 0 0 14 CCR§18459.3-Retention of Comprehensive Trip Logs for 3 years <br /> 0 0 14 CCR§18460.2-Manifest System Requirements for Registered Waste Tire Haulers 0 Referred/CalRecycle Enforcement <br /> LU <br /> 0 O 14 CCR§18461 -Manifest System Requirements for Waste Tire End-Use Facilities W <br /> 0 0 14 CCR§18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators In Compliance-No Violations o <br /> O O Oar.§ - <br /> Comments w <br /> S � _ <br /> Inspection Form Included: 0 <br /> Comments Included: (IJ <br /> Business Rep's gnatLre Phone Number -ids to Si ature Phone Number <br /> INSTRUCTIONS ON BACK Correct:10 Incorrect: KA � [—E]X A L E 1112 3 62081 <br /> White Copy:CalRecycle Yellow Copy:Operator Pink Copy:LEA <br />