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C - <br /> Ht►.JLER OBSERVATION REPORTXX <br /> Observation Report Number <br /> CalRec cle s�°°rc,lifor n: IH-=00L <br /> Y CdRecpoia XXX(Rev X=) <br /> Dq,Ld •zwd BLUE OR BLACK INK PEN <br /> 77 <br /> 0 TPID-not available/not applicable <br /> ® Observation during inspection at: ����l'P) 7m' <br /> TPID- 7 S �� -� Ql' Generator p End-Use Facility p Other. <br /> TPID=I L -j `-t -g 137 s - t v1 1 I <br /> Vehicle ( , <br /> Plate L `( k Z( II Fj State L Q Observation in transit <br /> Decal Observation by Inspector <br /> Number CD Y - F j o t �Am 8u, .-A <br /> (RApplicable) <br /> Observation Date I f , <br /> Q Hauler Exempt: <br /> Hauler Name Observation Time <br /> At ���� M,Gula�� C'u �t��f_�� �: 1 5 µ4. <br /> H`a`uler Address <br /> Now <br /> City State Zip Code <br /> Driver's Name D.O.B. <br /> 7 <br /> Location of ObservationY. <br /> {y <br /> Street <br /> C/A more information concerning Waste/Used Tire <br /> city state Zip code Hauling&Manifesting,please call the Waste Tire <br /> Hotline at(866) 896-0600. <br /> S. <br /> Part B- <br /> Q ® PRC§42951-Waste Tire Hauler Registration and Transport of Tires Q Q PRC§42956(c)-Failure to Present Registration to 081cia1 <br /> Q Q PRC§42952(b)-Falsely Represents Self as Registered Hauler Q Q 14 CCR§18456.4—Failure to Abide by Temporary Registration <br /> Q Q PRC§42956(a)-Registration/Decal in Vehicle Q Q 14 CCR§18459-Hauler Complying with Manifesting Requirements <br /> O Q PRC§42956(b)-Hauler Using an Unregistered Vehicle Q Q Other§ <br /> Comments/Driver's Statement: <br /> �__.... _..ter__...L__—Lt.�'1G.�_.fJ�_.._P_� �1�.1.J� L�L ._-•��C��..�'�_tLY._ <br /> -�..v1���__P, '3'.-rt-j Sem• • .._���1..�sX�—'�...._.____]�-----��✓- ,�.�-�� <br /> _._-��.�'fT._►_�' ----�^�.._. �..__� ►7 L�it_��/ \j.'aYL--�.(�51.__._�''e�1.C7._3.�." <br /> _ _. .►!__ iHJY�'.t� !l -5Tr <br /> z�G.'� . <br /> tM rr?d7: � r� r'`vVd�a'� �;• 5�r �: 't'5! st r h d ' �'� .1>. *' f° <br /> a; r Ygr' 19Qaytt[e4,rai �t? o 1 ecto s �n <br /> Correct: Incorrect: M a o J <br />