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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste floresurvey and Inspection Repo 304 E WEBER AVE 3RD FL <br /> STOCKTON CA 95202-2708 <br /> :e of Califomia (209) 468-3420 <br /> /MB-54(10103) <br /> Page �2 of <br /> ,RT D -Notes Ins on ate: <br /> ile Number: <br /> ',usin s Fa ility Name: <br /> G oo di ates: <br /> c <br /> o <br /> I <br /> "Follow-up: ❑ Violation re-inspection ❑ Refer to CIWMB Da e: <br /> Date: ❑ Other Referrals <br /> No tires, remove. Out of business, remove. <br /> NFA required. ❑ <br /> Phone:L� - 033 Z-� <br /> Inspector's Signature <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />