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4Ra�1~ SSAN JOAQUIN COUNTY <br /> a �'•.o <br /> r• � ENVIRONMENTAL HEALTH DEPARTMEIv r <br /> e < 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 <br /> `+e1Foa"xa LIQUID WASTE OFFICIAL INSPECTION REPORT <br /> S=Structure O=Operation <br /> S O Package Sewage Plant NAME OF FACILITY INSPECTION DATE <br /> 1. Grease Trapo2 <br /> 2.Lift Pum PREMISE DRESS REINSPECTION DATE <br /> 3.Fence Locked . r <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 23 _ z <br /> 8.Blower Aerator <br /> 9. Skimmers Clarification / 2 <br /> 10. Aerator-Color <br /> 11. Sludge Return <br /> 12.Effluent Clarity <br /> 13.Polish Ponds <br /> 14.Excess Sludge 14 <br /> 15.Sludge Bed 5` <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 y <br /> 22.Yard/Equipment Maintenance tit <br /> 23.Failure Evident p <br /> 24.Monitoring Report <br /> 25.Monitoring Well / <br /> S O Chemical Toilets <br /> I.Tank Capacity <br /> 2. Storage Site <br /> 3.Disposal Site <br /> 4.Type of Chemicals <br /> 5.Unsanitary Condition Iyrrc <br /> 6.Doors Self Close/Locking _ <br /> 7.Vector Proof L <br /> 8.Surfaces Smooth/Easily Clean <br /> 9.Floor w/Urinal 10 sq.ft. 4414 I�Al <br /> Floor w/oUrinal 8 sq.ft. WA <br /> In eaa:.;---I A___,__:.,_r,__.,Washin -r <br /> .S os r trr/Lcoo fv <br /> ro u <br /> W N <br /> z C0,01 ta227Z29M. �aC. <br /> iso <br /> Z a5 ¢ u aci 3" <br /> O z as <br /> ^-otl V W U L V 6 - <br /> z �w F g 3 s u �r¢/Kt { Abocrh'e ti cJ S�G e L d• cam <br /> O = V W75 s <br /> FO <br /> z a Q@ i'✓•7u Ytl'L-S LY Lx-af/-wL✓L4' .� 2. <br /> Wd Z rl 'Tett , Unrt 1'Jz/ yet-�^" 3) Ur'�c.-v+.c N.'4-r,�• <br /> W d o s U LL �Lr M� <br /> PROGRAM ELEMENT: 2 3 Z PROGRAM RECORD: ` •� <br /> M W N <br /> RECEIVED BY: DATE <br /> R.E.H.S. DATE: 2 O <br /> a X'n 3 / <br /> Enn42 v9 t¢i W <br /> 31IORM <br />