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ENVIRONMENTAL HEALTH <br /> Waste 'lire Survey and Inspection Report SAN JOAQUIN COUNTY <br /> 'e of Califomia 304 E WEBER AVE 3RD FL <br /> !MB-54(10/03) STOCKTON CA 95202-2708 <br /> (209) 468-3420 <br /> SRT D - Notes <br /> ile Number: Page of <br /> In on ate: <br /> 3usiness/Facility Na <br /> GP Co rdinates: <br /> ivoLAJ A-5 <br /> . <br /> 6 kpze 6 <br /> d 2-- s <br /> Lj <br /> of low-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 Stgnatur <br /> L2,0,_�LL 0 Phone: <br /> White Copy: CIWMB Yellow Copy. Operator Blue Copy: LEA <br />