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ENVIRONMENTAL HEALTH <br /> Waste ._.,e Survey and Inspection Reporn SAN JOAQUIN COUNTY <br /> !s of California <br /> 304 E WEBER AVE 3RD FL <br /> 'JMB-54(10/03) STOCKTON CA 95202-2708 <br /> (209) 468-3420 <br /> SRT D - Notes <br /> I-e Number: Page of <br /> Ins do Date: <br /> 3us ness/Facili Name: <br /> GPS Coordinates: <br /> �Q_ N <br /> ` V <br /> .otlow-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 /> ispector's Signature _Q1 �kuL �a— C Z <br /> Phone: <br /> White Copy: CIWNIB Yellow Copy. Operator Blue Copy: LEA <br />