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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste :.e Survey and Inspection Repo? 304 E WEBER AVE 3RD FL <br /> STOCKTON CA 95202-2708 <br /> if California (209) 468-3420 <br /> 4MB-54(10/03) <br /> PART D -Notes <br /> Page 7—d <br /> File Number: Inspection Date:6 1 O <br /> Business/ Facili Name: ! ' 11�1� GPS Coordinates: <br /> 40 <br /> Y\ <br /> c� � b✓ <br /> V��• �j C�v--� Lt Cwt(G�,� <br /> P� r�'CfL r1r W14— <br /> �- w;1 <br /> 14 <br /> Follow-up: <br /> ❑ Letter of Violation ❑ Violation re-inspection E] Refer to CIWMB Date: <br /> Date Mailed: Date: <br /> ❑ Other Referrals <br /> ❑ If this box checked NFA required. ❑ No tires, remove. ❑ Out of business, remove. <br /> Inspector's Signature <br /> Phone: <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />