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Please print neatly and fill in all the applicable bubbles or boxes on the
forms. Use a blue or black ink pen only.
Page 1 (Survey Form) | Page 2
(Inspection Form) | Inspection Forms
Page 1--Survey Form (CIWMB 181)
Part A: Survey
Business Profile
TPID: The complete TPID (Tire Program Identification Number)
including the suffix is an essential part of the inspection form. If the
location under investigation needs a TPID and does not have one, the
inspector is to call 1-866-896-0600 and help the operator obtain a TPID.
Local Identifier: This space has been included to provide the
grantees with an opportunity to link the inspection form to their local
database. If you don’t have a local number to fill in this space, leave it
blank.
Business or Facility Name & Physical Address: Include the business
name and physical address in this section (please print neatly).
Business Rep: This is the person that was contacted and authorized
the inspection/visit.
Tire Count: Use whole tire
counts/Passenger Tire Equivalents (1 PTE = 20 lbs.) or both. Tire pieces all
the way down to ¼” in size are regulated and should be included in the tire
count. Do not count tires that meet the rack and stack criteria.
GPS: Take a reading using a Global Positioning System (GPS) unit
or obtain the coordinates from a map program using the facility/site address
and record the readings in this section. Record the latitude/longitude in
decimal degrees.
Inspection Details
Inspection Type: Fill the bubble that describes the inspection
type.
- A routine or periodic inspection or visit is prompted by regulation (e.g.
minor waste tire facility permits are required to be inspected at least
every 30 months and majors are to be inspected annually) or by the
inspectors schedule, set to insure periodic visits of each location within
their jurisdiction.
- A re-inspection is always preceded by an inspection in which a violation
was cited. The Inspection Type will be considered a re-inspection until the
violation is corrected.
- Observation is an Inspection Type that is spontaneous. (e.g. The
inspector is in the field and sees a tire facility, a pile of tires or
anything that causes them to inspect the site.)
- A Referral Inspection Type is prompted by the CHP, CIWMB,
a complaint, an Educational Visit request from
the CIWMB Hauler Unit, or by some Other agency. If the Referral box is
checked, the inspector is to also select the corresponding Referral Type.
Always try to find out from the referrer the appropriate Referral Type. If
the Other (Referral Type) bubble is selected, name the referring agency (any
local, state or federal agency) in the comment section of the report.
- The Educational Visit Referral Type is prompted by the Waste Tire
Manifesting System database (WTMS) when multiple manifesting errors are
detected over a set period of time. The WTMS Educational Visit is a Referral
Type that prompts a focused inspection/visit to provide manifest training to
a hauler, generator, or end use facility.)
Inspected By/Inspector: The inspector’s name and the applicable
county or state code are to be recorded in this section. The county code
begins with the traditional county number and ends with an assigned
three-digit number.
Inspection Dates and Times need to be completed to provide the
site’s history of compliance. This information is vital for agenda items and
court hearings.
Operational Status:
- Active: Active tire operation
- Closed: All the tires have been removed and operations are no
longer, or never were, conducted at this location
- Inactive: Tires are present but operations are not active
- Planned: Location where waste tire activities are proposed.
Tire Type: Fill in applicable tire types stored on site. OTR = off
the road tires
Business Role and Storage Type: Fill in all that apply. Specific
standards are associated with indoor (14 CCR 17356) and outdoor (14 CCR
17354) tire storage.
Business Type: A business may conduct multiple activities (or
business types) at one location. If the list of business types on the survey
form does not contain the business type conducted at the location of the
visit, choose other and print in the appropriate business type.
Part B: Inspection of Waste Tire Dealer Generator, Hauler, and End-Use
Facility
V = Violation
A = Area of Concern—considered a warning, not a violation
- PRC § 42951: Use to cite unregistered haulers.
- PRC § 42953: Cite the person(s) that contract or use unregistered
haulers to transport 10 or more waste or used tires.
- PRC § 42956: Cite haulers for missing or improperly placed decals or
certificates.
- 14 CCR § 18459: Cite exempt or registered haulers, facilities or
generators for not completing, signing, or using logs and/or manifests.
- 14 CCR § 18459.1: Choose this section to cite anyone who doesn’t have
(but needs) a TPID.
- 14 CCR § 18459.2.1: Cite for exceeding manifest document submittal time
limit (90 days).
- 14 CCR § 18459.3: Cite if records are not retained for 3 years.
- 14 CCR § 18460.2: Cite registered haulers for not showing proof that the
vehicle is registered, incomplete manifests, not carrying copies of
manifests and trip logs in the vehicle, not leaving a copy of manifests
anywhere tires are dropped off or picked up, hauling waste tires to
unauthorized locations, not reporting generators or end use facilities that
do not use or properly complete the manifests, transporting tires without
completed manifest forms and/or trip logs.
- 14 CCR § 18461: Cite the end use facility for manifest violations,
record retention, mailing forms.
- 14 CCR § 18462: Cite tire dealers or waste tire generators for
manifesting violations, contracting or making arrangements with unregistered
haulers.
- Other: Cite CIWMB laws or regulations that are not listed on the
inspection report in this space. Cite any applicable (tire related) local
code violation in the comment section. Do not fill the Other bubble for
local code violations or record local code violations in this section.
Enforcement Status: If a violation is documented, fill in the
Notice Of Violation (NOV) bubble and assign a Compliance Deadline (give the
operator the Standardized NOV and the appropriate law or regulation
handout). The Compliance Deadline Date (CDD) is normally around 30 days.
However, the inspector may exercise their discretion when assigning a CDD.
If an Extension of the CDD date is granted, fill in the bubble and record
the new CDD. If the site/operator is referred for/or already under CIWMB
Enforcement or if the site/operator is referred to some other agency, fill
the referred/CIWMB bubble. Note the entity to whom the case was referred in
the comment section. If there are no violations found during the inspection,
fill in the In Compliance-No Violation bubble.
Comments: Summarize the inspection. Capture specific details that
may be useful in case prosecution or simply to convey information about the
site, operator, or the violation. If a violation is cited, be sure to note
that the NOV and applicable handouts were distributed to the Business
Representative.
Page bubble: (Lower Left) Fill in the bubble indicating if the
inspection form and/or extra comment form is included with the survey (page
1) form. Use page two, Inspection Form, for permitted & exempt facilities or
when an excluded facility is in violation of the Waste Tire Storage &
Disposal Standards.
Signatures: Sign the form and have the Business Representative
that authorized the inspection sign the form.
Page 2--Inspection Form (CIWMB 182)
NOTE: Use this page for unpermitted, permitted, exempted, and for excluded
facilities that are in violation of tire storage standards.
Part C: Facility Information
Business Profile
TPID: Please fill in the TPID. Make sure it is the same TPID that is on
page one.
SWIS: If the facility has a SWIS number, record that number in this
space.
Property Owner: The name and mailing address of the property owner is to
be included in this portion of the report. The property owner is ultimately
liable for tire storage violations at the location.
Inspection Details
Inspection Report Number: This is not a stand-alone form. Be sure to use
the same Report Number in this section that is displayed on the
corresponding Survey Form (page one).
Photos Taken: Fill in the bubble to indicate whether or not pictures were
taken during the inspection.
Exempt & Excluded Business Type: If the site is exempt or excluded, fill
in the applicable bubble. Please do not fill more than one bubble.
Exclusions cannot be combined with other exclusions, exemptions, or with a
permitted facility.
Permitted Regulatory Status:
- Permitted: The facility has a current waste
tire facility permit issued by the CIWM
- Exempt: The operator has a Cement
Manufacturing Plant Exemption that was issued by the Board
- Excluded: A
facility that fits into one of the excluded categories listed in Title 14, CCR §18420 or PRC §42808. Choose only one. Exclusions cannot be combined
with other exclusions, exemptions or with a permitted facility
- Unpermitted:
The facility does not have, but is required to have a valid permit,
exemption, or exclusion.
Facility Type: Fill in the applicable bubble & be sure the number of
waste tires or PTE on-site fall between the associated ranges.
Part D: Inspection of Waste Tire Facility
Waste Tire Storage Standards
Permit Requirements:
- PRC §42824. Cite this code for unpermitted major waste tire facilities
or for the directing, transporting, or accepting of waste tires at an
unpermitted major waste tire facility.
- PRC §42834. Cite this code for unpermitted minor waste tire facilities
or for the directing, transporting, or accepting waste tires at an
unpermitted minor waste tire facility.
- PRC §42850(a). Cite this code when a person negligently violates any
provision or any permit (term and condition), rule, regulation, standard, or
requirement issued or adopted in Chapter 16 of the PRCs.
- 14 CCR §18420(a). Cite when a waste tire facility operator does not have
a permit. Could be an unpermitted facility, excluded or exempt facility that
no longer meets exclusion or exemption criteria or a permitted facility that
let their permit expire.
- 14 CCR §18423. Use this citation when the operator fails to apply for a
major or minor permit or permit renewal.
- 14 CCR §18432. Cite permitted operator(s) for not keeping their
Operation Plan updated.
- 14 CCR §18433. Cite permittee for not maintaining a copy of Emergency
Response Plan (ER) at the facility, forwarding the ER to the fire
department, revising, updating, or notifying the Board of revisions to the
ER within 30 days, or for not notifying the Board of a fire event, or
submitting a written report to the Board describing the fire event within 30
days.
Record Keeping Requirements:
- 14 CCR §18447. Cite for not keeping records at the facility or lack of
record retention (3 year minimum).
Fire Prevention Measures:
- 14 CCR §17351. Cite for inadequate: communication equipment, fire aid
equipment, or water supply.
Site Security:
- 14 CCR §17352. Cite for not posting proper signs (public facilities
only), attendant not being present, ill maintained access roads, or lack of
access control (lockable gates, fences, etc.).
Vector Control:
- 14 CCR §17353. Cite for lack of/or ineffective vector control measures.
Storage of WasteTires Outdoors:
- 14 CCR §17354. When citing this violation, be sure to choose and fill
the appropriate subcategory bubble.
Indoor Storage:
- 14 CCR §17356. Cite violations of the National Fire Protection
Association, NFPA 231-1989. If necessary, solicit help from the local fire
protection agency--they can also approve alternative standards.
Inspection Forms |
