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ENVIRONMENTAL HEALTH <br /> A, SAN JOAQUIN COUNTY <br /> .- Waste Tire Survey and Inspection Report 304 E WEBER AVE 3' FL <br /> STOCKTON CA 95202-2708 <br /> State of California <br /> CIWMB-54(10/03) (209) 468-3420 <br /> PART D -Notes Page,Z of <br /> File Number: Inspection Date: <br /> 5_ Z7D• <br /> Business/Facility Name: !� GPS Coordinates: <br /> r c—, <br /> J 1 S _ <br /> c G <br /> __rA l r4r-: i i , <br /> Ij <br /> 40 X aeN v? <br /> 40 Q�10*11a, <br /> Yah 4•� !' �i GC 'H O t i <br /> C r` <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 Signatur L Phone: <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />