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Survey & Inspection Report cvey Form (Page 1) Page 2 of 3 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 ❑ ❑ 14 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 I. 1 114 CCR § 18461 - Manifest System Requirements for Waste Tire End-Use Facilities ❑ n 114 CCR § 18462 - Manifest System Requirements for Waste Tire Generators JI❑ 1 Other 14 CCR § ENFORCEMENT STATUS Notice of Violation Extension Compliance Deadline: (Required for NOV or EXT) Referred / CalRecycle Enforcement C In Compliance - No Violations Comments: A A Paragraph Font Family Font Sizes Routine waste tire inspection done on this date and the following was noted: No violations or areas of concern. Notes: 1.) Permission to conduct inspection was granted by Dan Bowman (Head Mechanic). 2.)TPID certificate is posted on the door of the shop office. 3.) Waste tires were counted directly. I Signatures Inspector's Signature Business Rep's Signature Upload Inspection Survey PDF Browse... Administrative Notes Message for CalRecycle: i https:Hsecure.calrecycle.ca.2ov/WTMS/Inspection/Survev.asDx?SurvevID=2443 00&OrLani... 1/9/2017