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-U SAN JOAQUIN COUNTY <br /> ENVI ONMENTAL HEALTH DEPARTMCIViT <br /> Ic <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> SOLID WASTE OFFICIAL INSPECTION REPORT Page of <br /> DBA INSPECTIO DAT <br /> SOLID WASTE F1 INFECTIOUS WASTE ' - - <br /> FACILITY ADDRFASREINSPE TION ATE <br /> il <br /> 1i t r� <br /> Structure Operation VEHICLES/EQUIPMENT .;. <br /> "I ISG"�rl� �r 11. M1--r' <br /> ❑ ❑ 1. Registration(DMV) OWNER/OPERATOR PHONE <br /> A � <br /> ❑ ❑ 2. Solid Waste Permit INSPECTION TYPE PROGRAM ELEMENT TOTAL#OF VEHICLES RECORD ID <br /> 'z <br /> /r <br /> ❑ ❑ 3. Infectious Waste Permit Mhe <br /> _ � /LL��items below represent code violations and must be corrected: <br /> ❑ ❑ 4. Identification: <br /> ❑ ❑ A 4"Name: <br /> x 1"Width ' 7�UVl ) 1 41� <br /> El ❑ B. ID Number: <br /> 4"Height x 1"Width ) �p �/na►I iv{ s rn �v1f <br /> El C. Lettering both sides �l�`�I A �I -�f /�Lti in ,�q/0 <br /> ❑ [15. Cleaning «�� 1 /� Y f <br /> ❑ ❑ 6. Maintenance <br /> ❑ ❑ 7. Tail Gate Seal <br /> 8. Car Tubes <br /> ❑ ❑ Carry Uv�i s96 IIYx)i+ -0 <br /> ❑ ❑ 9. Ride Steps , 1 <br /> ❑ (� 10. Broom/Shovel <br /> i ft'lC <br /> ❑ 11. Roll Off Covers <br /> ❑ ❑ 12. Leakage or Spillage <br /> Structure Operation C O N T A I N E R S <br /> ❑ ❑ 13. Identification over 1 yd <br /> ❑ ❑ A. Name <br /> ❑ ❑ B. Telephone Number <br /> El <br /> F <br /> Cleaning <br /> ❑ ❑ 15. Maintenance <br /> ❑ ❑ 16. Insects <br /> Structure Operation Y A R D S <br /> ❑ ❑ 17. Sanitation <br /> ❑ ❑ 18. Parking <br /> ❑ ❑ 19. Wash Down Facilities <br /> I'�Z k—�- IUfV L f'r r2cL'E ct>r`D UrJi?ItTr <br /> f3 <br /> ❑ ❑ Time/Method �1 <br /> 20.Hazardous Waste Storage RECEIVED INSPECTOR <br /> � ��:� <br /> EHD 44-01 4/12/12 SOLID WASTE OIR <br />