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HAULER OBSERVATION REPORT <br /> CalRecycle URe ycle 775(New 2/14) <br /> Drt otR­ —Recydlmgv,dR<co y BLUE OR BLACK INK PEN <br /> Hauler Profile Observation Details <br /> 0 TPID-not available/not applicable 0 Observation during inspection at: <br /> a Generator 0 End—Use Facility 0 Other: <br /> TPID- 1 0 0 0 8 0 1 — m <br /> TPID- 1 1 3 1 2 6 1 7 <br /> Vehicle 9 2 <br /> Plate State 0 Observation in transit <br /> Decal Observation by Inspector <br /> Number m 3 9 — 1 0 1 I Xiong <br /> (If Applica- <br /> 0 Hauler Exempt: Observation Date <br /> 0 Hauler name&address not known <br /> Hauler Observation Time <br /> AM <br /> Bridgestone Americas Tire Operations, LLC 1 1 : l o . <br /> Hauler Address rM <br /> 233 <br /> Street ENFORCEMENT STATUS <br /> Bellevue Ave <br /> City State Zip Code O Notice of Violation <br /> Santa Rosa CA 95407 <br /> Compliance Deadline <br /> Driver's Name D.O.B. <br /> m/ m/ <br /> Location of Observation 40 <br /> Referred/CalRecycle, Tire Hauler Compliance Unit <br /> Street <br /> For more information concerning Waste/Used Tire <br /> City State Zip Code Hauling & Manifesting, please call the Waste Tire <br /> Tire Load CountEl � Hotline at(866) 896-0600. <br /> (used+waste) I <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> O 0 PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> O 0 PRC§42952(b)-Falsely Represents Self as Registered Hauler O O 14 CCR§18456.4–Failure to Abide by Temporary Registration <br /> O O PRC§42956(a)-Registration/Decal in Vehicle 0 0 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O O PRC§42956(b)-Hauler Using an Unregistered Vehicle O O Other§ <br /> Comments/Driver's Statement: <br /> 1.) Manifest search done on WTMS resulted in 6 manifest. All manifests were available and on site for review. <br /> Additional manifest for pick up on 10/28/15, 11/23/15, 12/09/15, 12/23/15, 12/30/15, 01/20/16, 02/03/2016, 03/02/16, <br /> 03/10/16, 03/16/16, 03/30/16, 04/07/16, 04/13/16, 04/14/16, 04/27/16, 04/14/16, 04/28/16, 05/11/16, 05/25/16, 06/08/16, <br /> and 06/22/16 were available for review. <br /> 2.)Additional manifests reviewed were not submitted to Cal-Recycle within 90 days of the the load shipment. <br /> Comment Form 0 <br /> Photos 0 Driver's Signature Phone Number Inspectors Signature Phone Number <br /> Correct : 40 Incorrect: X �r <br />