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Photo Log <br /> Facility: Wilson Way Tire Company, Inc. TPID: 1000837 <br /> Inspection Report: IW-1031840 Date: 12/3/2015 <br /> #jkir`ni--cQC r) FLEET SERVICE RECORD <br /> r <br /> Ory F X11 », I <br /> Y All?&CO.,'. <br /> TIRE SALES '-1 TERED FLEET SERVICE RECORD Salea <br /> kiln Blvd,. <br /> TPID 1000837. 1.7 5`j S 7 iasCA9 <br /> #02 Connelt 77re - —1 <br /> 2211 N.Wilson way021 US T/re Se/es #23 US 77re$ales7#24 US Tire Sates <br /> Stockton, 2600 Yosemite Blvd. 1915 National Ave. <br /> CA 95205 Modesto,CA 95354 6530 Franklin Blvd. <br /> 209-466.2581 209-571-5611 Heyward,CA 94545 Sacramento,CA 95823 <br /> 510-887-1282 916-395-2245 <br /> 41-5/PHONE�p/, P.O.#PHONE DATE [ ' 1 <br /> + <br /> � <br /> VEHICLE# <br /> C., P aDE <br /> LICENSE# <br /> STATE ZIP CODE , <br /> r <br /> ��ee of Csilfomis that the Information DECAL#AT <br /> y �--I l l- I �1 Ia1 ofrenewalof the Wsste Tire Haul RvIA�Btion is true snd correc. ddition,I am aware thatfaistfFcation of <br /> Idminlstretiw ptnalUes up to;5.000 pursuant to public Resources Code section 42060 and may <br /> Par violation per day as described in <br /> DRIVER SIGNATURE public Resources Code section 42062. <br /> X DATE <br /> LICENSE STATE ODOMETERIHUB <br /> ON OFF <br /> WORK Qn DESCJ7IP77ON OP 1MORK COMPLETED <br /> O NTfD'SMOUNT(S)ON V HI <br /> Photo: 15 of 20 <br /> Description: <br /> Manifests failed to be submitted to WTMS within the 90-day requirements, and is in violation of 14 CCR, <br /> Section 18456.2.1(b),the waste tire hauler shall submit a completed manifest form to the Department <br /> within 90-days of load shipment. 15 <br />