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'ENVIRONMENTAL HEALTH <br /> Waste i..e Survey and Inspection Report SAN JOAQUIN COUNTY <br /> rz of California <br /> 304 E WEBER AVE 3RD FL <br /> VMB-54(10/03) STOCKTON CA 95202-2708 <br /> (209) 468-3420 <br /> SRT D - Notes <br /> ile Number: Ins tion ate: Page7of Z <br /> 3us'ness/Facility Name: GPS oordinate <br /> s <br /> 41-) CidAl <br /> \ 00 `tom) S <br /> I� 2 <br /> J — <br /> V r—� <br /> 2 <br /> =ollow-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. <br /> ❑ Out of business, remove. <br /> nspector's Signature <br /> Phone: <br /> White Copy: CPVMB Yellow Copy Operator Blue Copy: LEA <br />