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Survey & Inspection Report -4vey Form (Page 1) Page 1 of 3 <br /> Waste Tire Management <br /> System 3.86.0062 Authorized Use Only Home I Reports I Help I Sign Out <br /> Hide Survey Form (Page 1): Raley's 306 (TPID:1830737) <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 n Email Inspection To Facility Operator M Inspection Form Number: IW- <br /> this Inspection Emailed on 3/7/2017 1051658 <br /> electronic survey (open Documents tab) <br /> * TPID - Site Suffix: 1830737 - 01 <br /> Found in Database <br /> Raley's 306 <br /> 4255 E Morada Ln <br /> Stockton, CA 95212 <br /> Local Identifier: San Joaquin County <br /> Business Rep: Donna Mendes Title: Store Team Leader <br /> * 1fl Tire Count: 0 <br /> Latitude: Longitude: <br /> * Inspection Type: d Routine Re-inspection Referral i Observation Educational <br /> If referral, referral type: CHP CalRecycle Complaint Other <br /> Inspected By: 39-101 San Joaquin County v <br /> * Inspector: Lor Xiong v <br /> * Inspection Date: 3/2/2017 <br /> * Time In 12:40 PM <br /> ......................................-------.._..._._._....._. ----. <br /> * Time Out 12:55 PM <br /> * Operation Status Tire Type Business Role Storage Type <br /> Active Passenger Generator Outdoor <br /> Closed Altered Hauler Indoor <br /> Inactive <br /> Planned Truck End-Use Container <br /> OTR <br /> Business Type: <br /> L. New Tire Dealer ❑Auto Body ❑Agriculture Retreader <br /> [_ Used Tire Dealer❑ Hauler Government Crumb Rubber <br /> Service Station ❑Trucking Fleet(_]Collection Dismantler <br /> Auto Repair ❑ Car Dealer Shredder �_ Tire Derived Fuel <br /> FV Other Business Type Other: Grocery Store <br /> https://secure.calrecycle.ca.gov/WTMS/Inspection/Survey.aspx?SurveylD=246876&Organ... 3/7/2017 <br />