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;- ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> -.--: Waste Tire Survey and Inspection Report 304 E WEBER AVE 3pj' FL <br /> --- STOCKTON CA 95202-2708 <br /> State of California <br /> CIWMB-54(10/03) <br /> (209) 468-3420 <br /> PART D - Notes Page of Z <br /> File Number: Inspection Date: <br /> F- / L, i- <br /> Business/ Facility Name: n GPS Coordinates: <br /> '25 Z�`� <br /> ' r <br /> J err; -�'�- �-- �n•� ���� C � ����,- <br /> x <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: QQ '/Z c Phone: L�6 <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />