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Survey & Inspection Report - `' vey Form (Page 1) Page 1 of 2 <br /> Waste Tire Management <br /> System 3.86.0049 Authorized Use Only Home I Reports I Help I Sign Out <br /> Hide urvey Form (Page 1): George Kishida,Inc. (TPID:1376696) <br /> Report is in SUBMITTED status - CalRecycle approval of this inspection report is <br /> pending. <br /> Survey Submitted for CalRecycle review. <br /> Part A- Survey <br /> Create PDF from M Email Inspection To Facility Operator 2 Inspection Form Number: IW- <br /> this Inspection Emailed on 7/18/2016 1041581 <br /> electronic survey (open Documents tab) <br /> * TPID -Site Suffix: 1376696 - 01 <br /> Found in Database <br /> George Kishida, Inc. <br /> 1725 Ackerman Dr <br /> Lodi, CA 95240-6330 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Kellie Kishida Title: Owner <br /> * M Tire Count: 86 <br /> Latitude: o Longitude: o <br /> * Inspection Type:EZ Routine❑ Re-inspection❑ Referral ❑Observation <br /> If referral, referral type:❑ CHP❑ CalRecycle ❑ Complaint❑ Educational Visit ❑Other <br /> Inspected By: 39-101 San Joaquin County <br /> * Inspector: Harprit Mattu <br /> * Inspection Date: 7/18/2016 <br /> * Time In 1:05 PM <br /> * Time Out 1:25 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active ❑ Passenger 0 Generator Outdoor <br /> Closed ❑Altered ❑ Hauler Indoor <br /> Inactive <br /> Planned 0 Truck ❑ End-Use ❑ Container <br /> ❑ OTR <br /> Business Type: <br /> ❑ New Tire Dealer ❑Auto Body ❑Agriculture ❑ Retreader <br /> ❑ Used Tire Dealer❑ Hauler ❑Government❑ Crumb Rubber <br /> ❑Service Station [Z Trucking Fleet❑Collection ❑ Dismantler <br /> ❑Auto Repair ❑ Car Dealer ❑Shredder ❑Tire Derived Fuel <br /> ❑Other Business Type Other: <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=235688&0rga... 7/18/2016 <br />