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EHD Program Facility Records by Street Name
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ELEVENTH
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7928
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4700 - Waste Tire Program
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PR0534903
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:19:29 AM
Creation date
4/29/2020 11:40:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0534903
PE
4740
FACILITY_ID
FA0020184
FACILITY_NAME
A1 TRACY AUTO GTR
STREET_NUMBER
7928
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95304
APN
25015001
CURRENT_STATUS
02
SITE_LOCATION
7928 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
CField
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EHD - Public
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Waste Tire Sup Bey & Inspection Report nspection Report Number <br /> state of California <br /> CalRecycle — <br /> CalRecycle 181(Rev.10110) Survey Form - Page 1 I1 1177676 <br /> Dept.of Resources Recycling and Recovery(CalRecycle) <br /> Part A-Survey BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- Inspection Type(Fill one) <br /> Site Suffix: 1 15 Q ® Routine Q Re-inspection Q Referral Q Observation <br /> Local f_ If Referral,choose referral type(Fill one) <br /> Aj <br /> Identifier: �' `-v Q CHP Q CalRecycle Q Complaint Q Educational Visit Q Other <br /> Business or Facility Name Inspected By Inspector <br /> Physical Address C 01 <br /> Inspection Date / / Z_ <br /> Time In Time Out <br /> Business Rep Tittll+e� } l ®AM O AM <br /> ( <br /> � /���I�t.l� C_.t-✓12�+� 4 ✓� � O PM � T � � ® PM <br /> Operational Status Tire Type Business Role Storage Type <br /> Tire Count (Whole/PTE) (Fill one only) (Fill all that apply) (Fill all that apply) (Fill all that apply) <br /> Active ® Passenger 0 Generator ® Outdoor <br /> O Q Closed Q Altered <br /> GPS Latitude Q Hauler ® Indoor <br /> O Q Inactive Q Truck <br /> Longitude - 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 /> �� G <br /> Q Service Station Q Hauler Q Agriculture Q Shredder ® Other :z/.yam �- <br /> Part B -Inspection of Waste Tire Dealer,Generator, Hauler and End-Use Facility ENFORCEMENT STATUS <br /> V A HAULING AND MANIFEST REQUIREMENTS <br /> Q Notice Of Violation Q Extension <br /> Q Q <br /> 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 /> Q Q 14 CCR§18459.1 -Tire Program ID Number from CalRecycle <br /> Q Q 14 CCR§18459.2.1 -Submittal of Comprehensive Trip Logs within 90 days (Required for NOV or Ex7) <br /> _ a <br /> Q O 14 CCR§18459.3-Retention of Comprehensive Trip Logs for 3 years o <br /> Q O 14 CCR§18460.2-Manifest System Requirements for Registered Waste Tire Haulers Q Referred/CalRecycle Enforcement <br /> W <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 *in Compliance-No Violations o <br /> Q 1 Q 1 Other:§ <br /> Comments <br /> 66K j*rimkr' <br /> Inspection Form Included: Q / to _` U 3 6—01 <br /> Comments Included: <br /> Business Rep's Signature Phone Number p r' gnature Phone Number <br /> INSTRUCTIONS ON BACK Correct: Incorrect: E X A M�P L E 1 2 3 62081 <br /> :X*�Qlf <br /> ® White Copy:CalRecycle Yellow Copy:Operator Pink Copy:L <br />
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