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w S'`` 4JOAQUIN COUNTY LIC HEALTH SERVICES <br /> VIRO ALT DIVI <br /> 5 N S JOA UI , PHONE (209) —3420 <br /> P 0 BOX 2009, STOCKTON, CA 95201 <br /> WASTE MANAGEMENT/SOLIINSPECTION FORM <br /> SOLID WASTE O INFECTIOUS WAST <br /> COMPUTER NO. <br /> PERMIT NO. <br /> pq In®peCtan Date <br /> VEHICLES/EQUIPMENT I -7 <br /> STR. O'ER. Prem�w a. <br /> 1. REGISTRATION (DMV) <br /> 2. SOLID WASTE PERMIT THE ITEMS BEL OW REP ENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> 3. INFECTIOUS WASTE PERMIT <br /> __. 4. IDENTIFICATION a'tkAif <br /> A. Name(4" Height) /SSI` <br /> Iq <br /> (1"Width) 13 (J <br /> B. ID Number(4" Height) 13 ll 0 S' <br /> (1" Width) <br /> C. Lettering both sides r I' <br /> 5 CLEANING Iq-)7zh 01336 <br /> / <br /> 6. MAINTENANCE �" ` <br /> 7. TAIL GATE SEAL I -1--1 i YAL Stn 7 <br /> &. CARRY TUBES <br /> 9. RIDE STEPS l Lt�t I 13-7 7 DIc <br /> 10. BROOM/SHOVEL 7 t <br /> 11. ROLL OFF COVERS 311 Vs <br /> 12, LEAKAGE OR SPILLAGE I leau <br /> SS <br /> CONTAINERS cS <br /> � <br /> 13.IDENTIFICATION over 1 yd.' 3 -7 �J <br /> A. Name �^ <br /> 319 <br /> 1 Q0 <br /> _.._ B. Telephone Number J 1 ) <br /> 14. CLEANING o fim E' <br /> 15. MAINTENANCE <br /> 16. INSECTS <br /> I Ite,oo M IMl S <br /> YAR <br /> rkv <br /> ® 17. SANITATION l -Tog Cpp Gt, <br /> 18. PARKING -32S7 <br /> ^ / /1 lC <br /> J ( 0 <br /> 19. WASH DOWN FACILITIES T <br /> --- a rio t /�► <br /> 20. HAZARDOUS WASTE STORAGE 1 , 239(o •,K <br /> TIME/METHOD <br /> &U <br /> 17 RECEIVED BY <br /> EH 08 01 <br />