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Survey &Inspection Report w ey Form (Page 1) . Page 2 of 3 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 ❑ ❑ 14 CCR § 18459.2.1 - Submittal of Manifest Forms and Tire Trip Logs within 90 days ❑ ❑ 14 CCR § 18459.3 - Retention of Manifest Forms and Tire Trip Logs for 3 years ❑ ❑ 14 CCR § 18460.2 - Manifest System Requirements for Registered Waste Tire Haulers ❑ ❑ 14 CCR § 18461 - Manifest System Requirements for Waste Tire End-Use Facilities ❑ ❑ 14 CCR § 18462 - Manifest System Requirements for Waste Tire Generators ❑ 1 Other 14 CCR § ENFORCEMENT STATUS ONotice of Violation Extension Compliance Deadline: (Required for NOV or EXT) OReferred / CalRecycle Enforcement ,!?In Compliance - No Violations Comments: U x x T ►— gE A A i Paragraph Font Family Font Sizesl T .l Routine waste tire inspection done on this date and the following was noted: No violations or areas of concern Notes: 1. Permission to conduct inspection given by Oscar Carillo, Manager. 2. Inspection was done with Oscar Carillo. 3. A direct count was used in counting the tires. v I I Signatures i]Inspector's Signature❑ Business Rep's Signature Upload Inspection Survey PDF Browse... Administrative Notes Message for CalRecycle: A A`l Paragraph Font Family . Font Sizes b5!_LKJ https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveyID=247427&0rga... 3/14/2017