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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste f e Survey and Inspection A060 304 E WEBER AVE 3RD FL <br /> ='-. STOCKTON CA 95202-2708 <br /> tate ofCalifomia (209) 468-3420 <br /> IWMB-54(10103) <br /> Page.2—of Z'ART D -Notes <br /> File Number: Inspection Date: <br /> 5 l7 <br /> Businss/Facility Nam `� GPS Coordinates: <br /> r <br /> i <br /> FFollow-up: Violation ❑ Violation re-inspection ❑ RefertoCIWMB Date:led: Date: <br /> ❑ Other Referrals <br /> ❑ If this box checked NFA required. ❑ No tires, remove. ❑ Out of business, remove. <br /> Phone: <br /> Inspector's Signature" <br /> hite Copy: CIWMB Yellow Copy Operator Blue Copy: LEA <br />