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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> 3"D FL <br /> Waste Tire Survey and Inspection Report 304 E WEBER AVE <br /> "' STOCKTON CA 95202-2708 <br /> State of California (209) 468-3420 <br /> CIWMB-54(10/03) <br /> PART D -Notes Page of <br /> File Number: Inspection Date: 6 Al <br /> Business/ Facility NaTg GPS Coordinates: <br /> el <br /> CA Go <br /> 1Qn3oD <br /> �'.. c <br /> , L <br /> 1 <br /> Follow-up: Refer to CIWMB Date: <br /> ❑ Letter of Violation ❑ Violation re-inspection ❑ <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 Phone: �j 29Z <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />