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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> :A <br /> Waste _ e Survey and Inspection Repo 304 E WEBER AVE 3' FL <br /> WN: STOCKTON CA 95202-2708 <br /> State of California (209) 468-3420 <br /> CIWMB-54(10/03) <br /> PART D -Notes Page�—of-2— <br /> File <br /> File Number: Inspection Date: <br /> 6 i,3 <br /> Business/Facility Name: GPS Coord nate : <br /> L� l <br /> j , <br /> O.-G �^� L��U ei `� 1r�LS a� <br /> C✓ r 7 � v <br /> ve, <br /> eAl <br /> -T` d _ ra <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 Signatur Phone: <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />