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11 <br /> 5/22/2017 Survey& Inspection Report-Survey Form(F 1) <br /> Waste Tire Management <br /> System 3.86.0067 Authorized Use Only Home I Reports I Help I Sign Out <br /> H LFI <br /> e(Survey Form(Page 1):Tracy Caltrans Mtce(TPID:1271895) <br /> � Report is in SUBMITTED status - CalRecycle approval of this inspection report is pending. <br /> Survey Submitted for CalRecycle review. <br /> Part A- Survey <br /> Create PDF from A Email Inspection To Facilitv Operator Efl Inspection Form Number: IW- <br /> this Inspection Emailed on 5/22/2017 1055344 <br /> electronic survey (open Documents tab) <br /> * TPID - Site Suffix: 1271895 - 01 <br /> Found in Database <br /> Tracy Caltrans Mtce <br /> 2005 Krohn Rd <br /> Tracy, CA 95377-9120 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Esther Herschbach Title: Caltrans Maintenance Super <br /> * P]Tire Count: 48 <br /> Latitude: ° Longitude: <br /> * Inspection Type: *f Routine Re-inspection Referral Observation Educational <br /> If referral, referral type: CHP CalRecycle Complaint Other <br /> Inspected By: 39-101 San Joaquin County T <br /> * Inspector: Lor Xiong T_ <br /> * Inspection Date: 5/16/2017 <br /> * Time In 12:58 PM <br /> * Time Out 1:08 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active d Passenger •' Generator ✓ Outdoor <br /> Closed V Altered Hauler Indoor <br /> Inactive d Truck End-Use V Container <br /> Planned <br /> OTR <br /> Business Type: <br /> New Tire Dealer Auto Body Agriculture Retreader <br /> Used Tire Dealer Hauler V 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 /> Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility <br /> Part B - Inspection of Waste Tire Dealer, Generator, Hauler, and End-Use Facility <br /> V A HAULING AND MANIFEST REQUIREMENTS <br /> PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires <br /> PRC § 42953 - Contracts with Registered Waste Tire Haulers <br /> I I <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=252563&0rganizationTPID=1271895&lnspectionlD=&InspectedBy=O&RegE... 1/4 <br />