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^ i <br /> SAN JOAQUIN COUNTY <br /> �y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd I <br /> 04�fb���� LIQUID WASTE OFFICIAL INSPECTION REPORT <br /> I <br /> S--Structure O=0 eration <br /> S O Package Sewage Plant NAME FACILITY INSPECTION DATE <br /> 1.Crease Trap <br /> 2.Lift Pump PREMISE ADDRESS REINSPECTION DATE <br /> 3.Fence Locked <br /> 4.Cross Connection The items below present health code violations and most be corrected: <br /> 5.Odor <br /> 6.Vectors <br /> 7.Soil Erosion i <br /> 8.Blower Aerator <br /> 9.Skimmers Clarification 216 <br /> 10. Aerator-Color <br /> 11. Sludge Return <br /> 12.Effluent Clarity <br /> 13.Polish Ponds <br /> 14,Excess Sludge <br /> 15.Sludge Bed T <br />` 16.Weeds <br /> 17.Distribution <br /> 18.Water Level Pits <br /> 19.Sounding Tube <br /> 20.Intermittent Dosing <br /> 21.Hazard Unsanitary Condition <br /> 22,Yard/Equipment Maintenance <br /> 23.Failure Evident <br /> 24.Monitoring Report <br /> 25.Monitoring Well T- <br /> S 01 Chemical Toilets <br /> 1.Tank Capacity <br /> 2. Storage Site <br /> f 3.Disposal Site / <br /> k 4.Type of Chemicals <br /> 5.Unsanitary Condition / <br /> 6.Doors Self Close/Locking <br /> 7.Vector Proof <br /> 8.Surfaces Smooth/Easily Clean <br /> 9.Floor w/Urinal 10 sq.ft. <br /> Floor w/oUrinal 8 sq.ft. <br /> 10.Additional Area Inside Hand Washing <br /> 11.Lettering Height 3" O <br /> S O Pumper Trucks/Yards <br /> 1.Valid Permit/Registration <br /> 2.Pumping Records <br /> 3.Lettering: <br /> r Name(3"),Address(Y),Ca aci 3" <br /> Re istration Number(6") <br /> 4.Truck Tank: <br /> Metal Construction <br /> Leak Proof Valves <br /> Manual Valves <br /> Valve Location <br /> 5.Pumps Sealed <br /> 6.Hoses: <br /> Pump Hose Adequate PROGRAM ELEME PROGRAM RECORD: <br /> Cleaning Hose Adequate <br /> 7.Racks-Metal DATE: <br /> RECEIVED BY: <br /> 8.Yard Sanitation: <br /> Sanitary R. S. DATE: <br /> Adequate J <br /> EHD 4202.006 <br /> 3/10/2005 <br />