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ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY <br /> Waste x are Survey and Inspection Repo 304 E WEBER AVE 3' FL <br /> STOCKTON CA 95202-2708 <br /> State of California (209) 468-3420 <br /> CIWMB-54(10/03) <br /> PART D -Notes Page7—of 2, <br /> File Number: Inspection Date: <br /> l�, a <br /> Business/facility Name: GPS Coordinates: <br /> jj In �� <br /> r�L4,— <br /> V`^�1 V�7�'� GAJ' !h �+f � '�• <br /> � l ov% I <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 Signature Phone: <br /> White Copy: CIWMB Yellow Copy: Operator Blue Copy: LEA <br />