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Survey & Inspection Report - Survey Form (Page 1) Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0062 Authorized Use Only Home I Reports I Help I Sign Out <br /> Hide Survey Form (Page 1): Mossdale Elementary School (TPID:1827248) <br /> Report is in SUBMITTED status - CalRecycle approval of this inspection report is <br /> pending. <br /> Survey Submitted for CalRecycle review. <br /> Part A - Survey <br /> Create PDF from this 0 Email Inspection To Facility Operator [E Inspection Form Number: IW-1052556 <br /> electronic survey <br /> * TPID - Site Suffix: 1827248 - 01 <br /> Found in Database <br /> Mossdale Elementary School <br /> 455 Brookhurst Blvd <br /> Lathrop, CA 95330 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Gus Albiag Title: Head Custodian <br /> * 21 Tire Count: 0 <br /> Latitude: ` Longitude: o <br /> * Inspection Type: / Routine Re-inspection Referral Observation Educational <br /> If referral, referral type: CHP CalRecycle Complaint Other <br /> Inspected By: 39-101 San Joaquin County <br /> * Inspector: Lor Xiong <br /> * Inspection Date: 3/20/2017 <br /> * Time In 10:50 AM <br /> * Time Out 11:00 AM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active Passenger Generator Outdoor <br /> Closed Altered Hauler Indoor <br /> Inactive <br /> Planned Truck End-Use Container <br /> OTR <br /> Business Type: <br /> New Tire Dealer Auto Body Agriculture L] Retreader <br /> Used Tire Dealer Hauler Government❑ Crumb Rubber <br /> ❑Service Station Trucking Fleet Collection ❑ Dismantler <br /> [I Auto Repair Car Dealer Shredder ❑Tire Derived Fuel <br /> Other Business Type Other: Elementary School <br /> Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=247774&0rga... 3/21/2017 <br />