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i� <br /> ENVIRONMENTAL HEALTH <br /> Waste ire Survey and Inspection Report SAN JOAQUIN COUNTY <br /> to of Califomia 304 E WEBER AVE 3RD FL <br /> VMB-54(10103) STOCKTON CA 95202-2708 <br /> (209) 468-3420 <br /> kRT D -Notes <br /> :ile Number: Page o{� <br /> Inspection Date: <br /> 3usiinness/Facility Name- _ 57- D <br /> ``` GPS Coor inates: <br /> a- 1 <br /> C ` <br /> ?0— <br /> he <br /> W <br /> =ollow-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 /> nspector's Signatu Phone: �000 —C33-Z <br /> White Copy: CIWMB Yellow Copy. Operator Blue Copy: LEA <br />