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EHD Program Facility Records by Street Name
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4700 - Waste Tire Program
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PR0524076
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COMPLIANCE INFO
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Entry Properties
Last modified
4/23/2020 9:05:58 AM
Creation date
4/22/2020 11:18:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0524076
PE
4740
FACILITY_ID
FA0015563
FACILITY_NAME
EVERMAN BRAKES/WHEELS AUTO REPAIR
STREET_NUMBER
2505
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
952053528
APN
14128312
CURRENT_STATUS
02
SITE_LOCATION
2505 E HARDING WAY
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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CField
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EHD - Public
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r:- Waste Tire Sur* & inspection Report _ ispection Report Number <br /> 'II032 State of California - 7 <br /> CIWMB 181( ew 04/04)California lntegrat dWasteManagementBoard Survey Form - Page 1 t II <br /> Part A- Survey BLUE OR BLACK INK PEN <br /> - Inspection Type (Fill one) <br /> Site Suffix: � � i % F(7� <br /> Site Lr 1 a Routine Q Re-inspection Q Referral Q Observation <br /> Local If Referral,choose referral type(Fill one) <br /> Identifier: 16 Wk 1\ 001 t �' Q CHP Q CIWMB Q Complaint Q Educational Visit Q Other <br /> Business or Facility Name Inspected By Inspector <br /> Physical Address Li—rd <br /> Street <br /> r– �-- Inspection Date <br /> City State ZIP Cade Time In Time Out <br /> Business Rep Title OAM <br /> PM 0 PM <br /> Operational Status Tire Type Business Role Storage Type <br /> he Count(I�VhOI <br /> e/ATE)) (Fill one only) (Fill all that apply) (Fill all that apply) (Fill all that apply) <br /> Q Active Q Passenger Q Generator Q Outdoor <br /> � Q Closed Q Altered <br /> GPS Latitude � j � , j + tl j p Q Hauler Q Indoor <br /> Q Inactive Q Truck <br /> Longitude _ <br /> g 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 <br /> 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 Q 14 CCR§18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators Q In Compliance - No Violations <br /> O O Other: § <br /> Comments I I <br /> co of of i 06( C V0V- <br /> - -VV' L4 ACI41 e (,k wJ vtl r l r o u Jit' CA <br /> T,1 <br /> Inspection Form Included: Q' <br /> Comments Included: Q - <br /> Business Rep's Signature Phone Number Inspector's Signature Phone Number <br /> INSTRUCTIONS ON BACK Correct:* Incorrect: X /P 'Xi A M P �J E _ 1 ; 2131 <br /> 62081 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />
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