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• ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste ire Survey and Inspection Repo[ 304 E WEBER AVE 3' FL <br /> ,tate of California STOCKTON CA 95202-2708 <br /> AWMB-54(10/03) (209) 468-3420 <br /> 'ART D - Notes Page.2 of <br /> File Number: Inspection Date: <br /> Business/ Facility Name: GPS Coordinates: <br /> l yy�5 <br /> ✓N :ASS <br /> �t7w <br /> 1 <br /> i &AGm <br /> C\\ C Q <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 Sig nat Phone: y53` 70y� <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />