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i <br /> SAN JOAQUIN COUNTY0 <br /> � <br /> �• ENVIRONMENTAL HEALTH DEPARTMENT <br /> ao 304 East Weber Avenue, 3'd Floor, Stockton, CA 95202-2708 <br /> r. Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> LIQUID WASTE OFFICIAL INSPECTION REPORT <br /> S--Structure 0=0 - <br /> S O Package Sewage ant NAME OF FACILI INSPECTION DATE <br /> 1,6rease Trap3� <br /> 2. Lift Pum PREMISE ADDRESS REINSPECTION DATE <br /> 3.Fence Locked , <br /> 4.Cross Connection The items below present health code violations and must be corrected: <br /> 5.Odor <br /> 6.Vectors <br /> 7. Soil Erosion <br /> 8.Blower Aerator <br /> 9. Skimmers Clarification , , <br /> 10.Aerator-Color <br /> 11. Sludge Return <br /> { 12.Effluent Clarity <br /> 13.Polish Ponds /�i7h/`�G� <br /> 14.Excess Sludge <br /> r <br /> 15.Sludge Bed <br /> 16. Weeds <br /> 17.Distribution Box <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 `.�✓� �/ cw7 ! i <br /> 24.Monitoring Report l �, <br /> 25.Monitoring Well <br /> S O Chemical Toilets <br /> 1.Tank Ca acity 7 cs(�1J7 � t <br /> 2.Storage Site I <br /> 3.Disposal Site <br /> 4.Type of Chemicals J <br /> 5.Unsanitary Condition _ �!a �d��f�71 � • <br /> 6.Doors Self Close/Locking <br /> 7.Vector Proof PeAA <br /> 8. Surfaces Smooth/Easily Clean <br /> 9.Floor w/Urinal 10 sq.ft. 5G<fri <br /> Floor WoUrinal 8 sq.ft. <br /> 1 10.Additional Area Inside Hand Washing �[�j ifjt�5! <br /> 11. Lettering Height 3" <br /> S O Pumper Trucks/Yards <br /> 1.Valid Permit/Registration <br /> 2.Pumping Records f i <br /> 1 3.Letterin : <br /> Name(Y),Address(3),Capacity Y <br /> Registration Number(6" <br /> { 4.Truck Tank: <br /> Metal Construction <br /> Leak Proof Valves <br /> Manual Valves I <br /> Valve Location <br /> 5.Pumps Sealed <br /> 6.Hoses: <br /> Pump Hose Adequate PROGRAM ELEMENT: 7PROGRAm RECQRD: J�j� <br /> Cieanin Hose Adequate 192' <br /> 7.Racks-Metal <br /> RECEIVED BY: , DATE: O <br /> 8.Yard Sanitation: <br /> i <br /> Sanitary R.E.H. DATE: <br /> Adequate !/J <br /> EHD 42-02-006 - <br /> 3/10/2005 <br /> '" <br />