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HAULER OBSERVATION REPORT <br /> CalRecycle CalRecycle'775"(New?/14) <br /> n<,,, R­­y BLUE OR BLACK INK PEN <br /> Hauler Profile Observation Details <br /> Q TPID-not available/not applicable <br /> � Observation during inspection at: <br /> TPID- 1 1 0 1 0 0 8 0 <br /> Generator O End—use Facility O Other: <br /> — 0 1 <br /> Vehicle TPID- 1 6 7 8 9 4 9 <br /> Plate State O Observation in transit <br /> Decal m _ Observation by Inspector <br /> Number3 9 =—I <br /> Xiong <br /> (If Applica- <br /> O Hauler Exempt: Observation Date <br /> Q Hauler name&address not known <br /> Hauler Observation Time <br /> GCR O "M <br /> 3 0 pM <br /> Hauler Address 1 2 <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. f�� <br /> Location of Observation <br /> Referred/CalRecycle, Tire Hauler Compliance Unit <br /> Street <br /> For more information concerning Waste/Used hire <br /> City State Zip Code Hauling & Manifesting, please call the Waste Tire <br /> Tire Load Count ❑'� Hotline at(866) 896-0600. <br /> (used+waste <br /> Part B - <br /> V A Hauler/Manifest Requirements V A Hauler/Manifest Requirements <br /> O O PRC§42951-Waste Tire Hauler Registration and Transport of Tires O O PRC§42956(c)-Failure to Present Registration to Official <br /> O Q 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 O O 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.) Search done on WTMS for"McKinney Trailer Rentals"from 08/26/2015 to present resulted in 30 manifests. <br /> During the inspection 10 additional manifests from"GCR"were onsite and available for review. The pickups are from <br /> 03/02/2016, 03/23/2016, 01/09/2016, 09/21/2016, 05/04/2016, 03/04/2016, 10/01/2015, 03/02/2016, 03/14/2016, <br /> and 03/17/2016. <br /> 2.)Additional manifests reviewed were not submitted to Cal-Recycle within 90 days of the load shipment. <br /> Comment Farm O <br /> 209-468-2807 <br /> Photos O Driver's Signature Phone Number Inspector's Signatur Phone Number <br /> Correct : Incorrect: X <br />