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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste 'I ire Survey and Inspection Repo► 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--of2^ <br /> File Number: Inspection Date: <br /> 1 U <br /> Business/ Facility Name: GPS Coordinates: <br /> Z -7 — v <br /> k\) <y.S 1 T- <br /> -� <br /> � � J <br /> � e <br /> l 4- <br /> ul r� <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 /> Phone: 2-1-6Z-Zl <br /> Inspector's Signature <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />