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... Waste ire Survey and Inspection Report City/CountyMailing Address <br /> State of California Phone Number <br /> CIWMB-54(10/03) <br /> PART D -Notes �A�- f3e, tiiv� .-� Ct�Q, 144-,� �- Page of ^y <br /> File Number: Inspection Date: <br /> 3 25 f✓ <br /> Business/,f acility Name: GPS Coordinated- <br /> 14v <br /> oordinate : <br /> GAG r-o uce_J 4w,;, I�tI S `T rCX <br /> c, <br /> 'L 5LX3 1"s <br /> 1 V� � ��1 /a,- <br /> M —r(2, In5�3 - !L <br /> e_ Th <br /> )(+w LA �cX 1 S Gi+�SCI eit c, �Y rr <br /> c� w �'r,� a t-� f -� r u' _ <br /> w;-1-6 4-4 e -P% <br /> I r.5 G, v_ r\ o f O err- 1 a( c <br /> 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 Phone: (Z01) qk52—Z`9S(1 <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />