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r <br /> HAULER OBSERVATION REPORT <br /> CalRec Cle Scaeuf California <br /> Y C.Mecycle 773(New 2/14) <br /> Dkp orR­R­h.p-JR­ry BLUE OR BLACK INK PEN <br /> IHauler Profile Observation Details <br /> O TPID-not available/not applicable <br /> Observation during inspection at: <br /> 0 Generator 0 End—Use Facility O Other: <br /> TPID- 1 S 2 1 2 6 9 0 1 <br /> TPID- 1 8 1 1 1 0 <br /> Vehicle State <br /> Plate Observation In transit <br /> Decal Observation by Inspector <br /> Number m 3 9 1 0 1 <br /> (If Applica- <br /> Q Hauler Exempt: Observation Date <br /> O Hauler name&address not known <br /> Observation Time <br /> Hauler <br /> Izzy's World Of TiresIS AM <br /> O C' PM <br /> Hauler Address � I <br /> 14090 _ <br /> Street ENFORCEMENT STATUS <br /> Alpine Rd <br /> City state Zip Code O Notice of Violation <br /> Lodi CA 95240 <br /> Compliance Deadline <br /> Driver's Name D.O.B. <br /> Location of Observation <br /> Referred/CalRecycle, Tire Hauler Compliance Unit <br /> Street <br /> For more information concerning Waste/Used Tire <br /> City State Zip code Hauling & Manifesting, please call the Waste Tire <br /> Tire Load Count ❑ I-lotline at(866) 896-0600. <br /> (used+waste) <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> O O PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> 0 Q PRC§42952(b)-Falsely Represents Self as Registered Hauler O O 14 CCR§18456.4—Failure to Abide by Temporary Registration <br /> O O PRC§42956(a)-Registration/Decal it Vehicle O O 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O O PRC§42956(b)-Hauler Using an Unregistered Vehicle O O Other§ <br /> Comments/Driver's Statement: <br /> 1.) During the inspection at"Pacific Tire" with TPID#1810001-01 1 observed 3 manifests from Izzy's "World of Tires ' <br /> that were not observed on WTMS. The manifests has past the 90 days and has not been reported to Cal-Recycle. <br /> The pickups were on 06/29/16, 06/07/2016, and 03/15/2016 with manifest numbers of 5582574, 5582571, and <br /> 5582560. <br /> Comment Form O <br /> (209)468-2807 <br /> Photos I' Driver's Signature Phone Number Inspector's Signature Phone Number <br /> Correct : Incorrect: X 411, <br />