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aa' �� SAN JOAQUIN COUNTY <br /> 4lII+r <br /> EN RONMENTAL HEALTH DEPARTMENT <br /> :< <br /> .304 East Weber Avenue, 3`'Floor, Stockton, CA 95202-2708 <br /> •', Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.sjgov.org/ehd <br /> LIQUID WASTE OFFICIAL INSPECTION REPORT. <br /> S--Structure 0=0eration .-.. <br /> S O Packa a Sewa a Plant NAME OF FACILITY INSPECTION DATE <br /> 1.GreaseTra __,-_ <br /> 2.Lift Pump PREMISE ADDRESS REINSPECTION DATE <br /> 3.Fence Locked jko 'U. <br /> 4.Cross Connection <br /> 5.Odor The items below present health code violations and must be corrected: <br /> 6.Vectors <br /> 7. Soil Erosion �� <br /> 8.Blower Aerator <br /> 9.Skimmers Clarification <br /> 10.Aerator-Color <br /> 11.S I ud e Return / S <br /> 12.Effluent Clarity <br /> 13.Polish Ponds L/ <br /> 14.Excess Sludge___ <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 J f <br /> 22.Yard/Equipment Maintenance <br /> 23.Failure Evident <br /> 24.Monitoring Report <br /> 25.Monitoring Well Xe- r <br /> S 01 Chemical Toilets <br /> 1.Tank Ca aci <br /> 2.Storage Site <br /> 3.Disposal Site <br /> 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" <br /> S O Pumper Trucks/Yards <br /> 1.Valid Permit/Registration <br /> 2.Pum ing Records <br /> 3. Lettering: <br /> Name(3"),Address(3"),Capacity <br /> Registration Number 6" <br /> 4.Truck Tank: <br /> Metal Construction <br /> Leak Proof Valves Ck' 2jz&6- <br /> Manual Valves <br /> Valve Location <br /> 5.Pumaled 17 1WX--77C!; //U,+ 2s""%tT <br /> 6.Hoses: r.✓ T//�SCc l�f' �� Tf`s 7�7d <br /> Pump Hose Adequate PROGRAM ELEMENT: J Li PROGRAM RECORD: <br /> Cleaning Hose Adequate <br /> 7.Racks-Meta] <br /> ECEIVED BY: #7ATE:l •- 1 /�$. Yard Sanitation: / Cl <br /> Sanitary R.E.H. DATE: �7 <br /> Adequate <br /> EHD 42-02-006 <br /> 3/10/2005 <br />