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HAULER OBSERVATION REPORT <br /> CalRec cle State'Wifomia <br /> y Cal Recycle 775(New 2/14) <br /> Ikpi dRaeo Rc,,,1,SdRc ,,c BLUE OR BLACK INK PEN <br /> Hauler Profile Observation Details <br /> O TPID-not available/not applicable <br /> Observation during inspection at: <br /> TPID- 1 8 1 2 1 2 6 9 <br /> Generator O End-use Facility O Other: <br /> 0 1 <br /> TPID- 1 2 1 9 1 0 3 1 3 1 6 <br /> Vehicle State <br /> Plate O Observation in transit <br /> Decal Observation by Inspector <br /> Number m EE — 1 0 1 I XIOng <br /> (If Applica- <br /> p Hauler Exempt: Observation Date <br /> Q Hauler name&address not known <br /> Hauler Observation Time <br /> 0 AM <br /> L : F]4-21 0 PM <br /> Hauler Address <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/Cal Recycle, Tire Hauler Compliance Unit <br /> Street <br /> I <br /> city state Zip Code For more information concerning Waste/Used Tire <br /> Hauling& Manifesting, please call the Waste Tire <br /> Tire Load Count ❑ Hotline at(866) 896-0600. <br /> (used+waste) <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> 0 O PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> O O 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 in 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.)A search done on WTMS for"Delgado Tires"TPID# 1290336 from 09/30/2015 to present resulted in 80 <br /> manifests. Most of the manifests were available on site for review during the inspection. 14 additional manifests <br /> from"Izzy's World of Tires"TPID# 1821269 were available on site for review. <br /> 2.)The 14 additional manifests reviewed were not submitted to Cal-Recycle within 90 days of the load shipment. <br /> 1� <br /> u <br /> Comment Form O <br /> (209)468-2807 <br /> Photos <br /> Driver's Signature Phone Number Inspector's Signat Phone Number <br /> Correct: 0 Incorrect: X Q� 0 <br />