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Waste Tire ManifestSystem—Field Reference Guide Comprehensive Trip Log Instructions (Completed by the HA ULER) 2 1. Enter hauler's decal number,vehicle license C Compre ansiue rlp L og and 11661 pts as plate number,and state of issuance. - wsTsucTio"�oN sA�KELICATE 2. Print hauler's business name,address,and phone number(including area code). If a 1 .- 2 t r rtuar a _ business stamp or label is used,it must be 3 applied on all copies of the CTL form. x 3. The hauler/driver prints name,signs,and dates top portion of the CTL form when ` completing the first receipt on the form. 2345 - C Fire Program N) Bite S 4. Enter Hauler's TPID number(including site Hauler uffix � Fasidry Telapliena suffix)on CTL receipt and hauler's phone 4 o number(including area code). Kauler Telei*mm"umber 5. Check the appropriate box to indicate if this transaction is a waste tire pickup or delivery, enter the load date(use the mm/dd/yy format), check the box for the appropriate load type, 5-1 1234567 and enter the load amount. Hauler Tire Program Site S.M. cii �eP ae er Enter the TPID number for the generator or I end use facility location.Print generator or end Hauler TeleRhrre Number use facility business name,address,and 6 �� phone number.If a business stamp or label is used,it must be applied on all copies of the CTL form. 1234567 -- A fit 7. After the hauler completes the CTL receipt, Hauler Tire Progrem 10 Site Suffix at a atlrw the generator or end use facility representative n tY a>a tern ar - � Q Q Q 0 will place their initials in the box provided Hauler Talopheee"umber indicating that they have reviewed the « information provided by the hauler and that rIL�( such information is true and correct. Know Your Responsibility! GENERATORS=If generators dispose of 10 or more waste For More Information tires outside of the business location,they are required to use Hotline(toll-free): 1-866-896-0600 a registered waste tire hauler and obtain a Tire Program Identification(TPID)number.A copy of the Comprehensive Website: www.ciwmb.ca.gov/Tires/ Trip Log(CTL)receipt will be retained at the place of business for three years. E-mail: WasteTireskciwmb ca ov HAULERS—You are required to complete the entire Mailing address Comprehensive Trip Log,obtain the initials of the operator, California Integrated Waste Management and submit a copy of the CTL form to the CIWMB within 14 Board days.A copy of the CTL form will be retained at the place of Waste Tire Hauler Program(MS-22) business for three years. P.O.Box 4025 END USE FACILITY—Is required to obtain a TPID number Sacramento, CA 95812-4025 and retain a copy of the CTL receipt at their place of business for three years. They may accept tires from an unregistered hauler transporting 10 or more tires or may accept tires from a registered hauler with no CTL receipt,but in both cases,the Publication#623-05-004 end use facility operator will complete an Unregistered Hauler Zero Waste California &Comprehensive Trip Log Substitution form.Unregistered MEMO ' Copyright 2005 by the California haulers transporting fewer than 10 waste tires are not required "`®®i Integrated Waste Management Board. to comply with the waste tire hauler registration or CTL requirements. All rights reserved.This publication, rii{A WAliF or parts thereof,may not be MAN^GEMtiN"C ""^x" reproduced without permission.