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•FACILOIES INSPECTION REPO► , <br /> OFFICE NO: 5S <br /> C <br /> INSPECTOR: TIMOTHY R. O'BRIEN PCA System Task No: <br /> 58392021002 TEICHERT AGGREGATES TEICHERT AGGREGATES-VERN <br /> ALIS <br /> WDS NUMBER NAME OF AGENCY OR PARTY RESPONSIBLE FOR DISCHARGE NAME OF FACILITY <br /> PO BOX 15002 36314 S.BIRD RD <br /> NPDES NUMBER <br /> AGENCY STREET FACILITY STREET I <br /> 010681 _ SACRAMENTO CA 95851 TRACY CA 95204 <br /> (1 (MM)(TYPE) AGENCY CITY AND STATE <br /> SCI1Ep INSPECT DATE AGENCY CITY AND STATE � <br /> BECKY WOOD Pz?Z'e <br /> AGENCY CONTACT PERSON FACILITY CONTACT PERSON <br /> (9161484-3351 <br /> _ACTUAL INSPECTION DATE =----�— AGENCY PHONE NO. FACILITY PHONI NO. <br /> TNSPFC:TTCIN TVPF. (C".hPrk nriP.) <br /> (A 1) "A"type compliance--Comprehensive inspection in which samples are taken. (EPA Type S) <br /> type compliance--A routine nonsampling inspection. (EPA Type C) <br /> (02) Noncompliance follow-up-=Inspection made to verify correction of a previously identified violation. <br /> E <br /> (03) Enforcement follow-up--Inspection made to verify that conditions of an enforcement action are being met. <br /> (04) Complaint--Inspection made in response to a complaint. x <br /> (05) Pre-requirement--Inspection made to gather info,relative to preparing,modifying,or rescinding requirements. . <br /> (06) Miscellaneous--Any inspection type not mentioned above. <br /> If this is an EPA inspection not mentioned above,please note type. <br /> (Type) (e.g.-biomonitoring,performance audit,diagnostic,etc.) <br /> i <br /> _ � I <br /> Were VIOLATIONS noted during this inspection? (Yes/No/Pending Sample Results) — � <br /> Was this p Quality Assurance-Based Inspection?(Y/IN) _ y <br /> Were bioassaysa les taken? <br /> � {N=No.If YES,then S w Static or F=)Flowthrough) E <br /> -- — INSPECTION SUMMARY (REQUIRED) (100 character limit) -- _-- <br /> -tom �Jv cls. <br /> Ir SM—Z22-.1 <br /> NSPECTOR'S DATA: <br />`ITIALS� SIGNATURE DATE <br /> or Internal Use:Reviewed By:(1) (2) (3) <br /> Reg.SWIM Coordinator <br /> 3WIM Data Entry Date' Regional Board File Number. I� <br />