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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste 'fire Survey and Inspection Report 304 E WEBER AVE 3' FL <br /> STOCKTON CA 95202-2708 <br /> State of California <br /> CIWMB-54(10/03) (209) 468-3420 <br /> PART D -Notes Page-2--of -2— <br /> File <br /> File Number: Inspection Date:5// <br /> Business/ Facility Name- GPS Coordinates: <br /> L � ' ✓ <br /> 1,4- T _o <br /> 46- <br /> L2 a. a�s o c, C_> -� <br /> Follow-up: <br /> ❑ Letter of Violation ❑ Violation re-inspection ❑ 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 ' _z Phone: <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />