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State of California <br />CIWMB-54 (10/03) <br />ENVIRONMENTAL HEALTH <br />SAN JOAQUIN COUNTY <br />Waste lire Survey and Inspection Repot, 304 E WEBER AVE 3' FL <br />STOCKTON CA 95202-2708 <br />(209) 468-3420 <br />PART D - Notes Page hof .4— <br />File Number: Inspection Date: <br />/-, 4 -- V 4 - <br />Business/ Facility Name: <br />GPS Coordinates: <br />White copy: UIVVMb reiiow copy: vperarur oiue Uupy. LC/-% <br />5' <br />r> <br />Follow-up: <br />❑ Letter of Violation <br />Date Mailed: <br />❑ If this box checked NFA required. <br />❑ Violation re -inspection <br />Date: <br />❑ No tires, remove. <br />❑ <br />❑ <br />❑ <br />Refer to CIWMB Date: <br />Other Referrals <br />Out of business, remove. <br />Inspector's Signature <br />Phone: <br />White copy: UIVVMb reiiow copy: vperarur oiue Uupy. LC/-% <br />