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Survey & Inspection Report-0ey Form (Page 1) • Page 2 of 3 Part B - Inspection of Waste Tire Dealer, Generator, and End-Use Facility Part B - Inspection of Waste Tire Dealer, Generator, Hauler, and End-Use Facility V A HAULING AND MANIFEST REQUIREMENTS ❑ ❑ PRC § 42951 - Waste Tire Hauler Registration and Transport of Tires ❑ ❑ PRC § 42953 - Contracts with Registered Waste Tire Haulers ❑ ❑ PRC § 42956 - Hauler Registration/Decal in Vehicle ❑ ❑ 14 CCR § 18459 - Responsible Entities Complying with Manifesting Requirements ❑ ❑ 14 CCR § 18459.1 -Tire Program ID Number and Certificate from CalRecycle ❑ ❑ 114 CCR § 18459.2.1 - Submittal of Manifest Forms and Tire Trip Logs within 90 days ❑ ❑ 114 CCR § 18459.3 - Retention of Manifest Forms and Tire Trip Logs for 3 years ❑ 114 CCR § 18460.2 - Manifest System Requirements for Registered Waste Tire Haulers ❑ ❑ 14 CCR § 18461 - Manifest System Requirements for Waste Tire End-Use Facilities ❑ ❑ 114 CCR § 18462 - Manifest System Requirements for Waste Tire Generators ❑ 1[] 1 Other 14 CCR § ENFORCEMENT STATUS �.--)Notice of Violation ,Extension Compliance Deadline: (Required for NOV or EXT) _:Referred / CalRecycle Enforcement *In Compliance - No Violations Comments: ( x, .xZ Xlh � ; '01 r� I B I o_ G' A - A - l Paragraph - Font Family - Font Sizes' Routine inspection conducted on this date and the following was noted: No violations or areas of concern. Notes: 1.)TPID certificate is posted behind the front counter. 2.) CTL search resulted in 1 manifest since the previous inspection. This manifest from "Izzy's World of Tires" Signatures Inspector's Signature Business Business Rep's Signature Upload Inspection Survey PDF i. Browse... Administrative Notes Message for CalRecycle: https:Hsecure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=240864&0rg... 10/10/2016