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�`�1" SAN JOAQUIN COUNTY <br /> �o. <br /> :a ENVIRONMENTAL HEALTH DEPARTMENT <br /> { <br /> _ 600 East Main Street, Stockton, CA 95202-2708 <br /> c31r1 'P Telephone:(209)468-3420 Fax:(209)464-0138 Web:Www.sjgov.org/ehd <br /> A��FOR� <br /> PUMPER TRUCKS/YARDS & CHEMICAL TOILETS <br /> OFFICIAL INSPECTION REPORT <br /> NAME OF FACILITY: h INSPECTION DATE: SIZ <br /> PREMISE ADDRESS: Q. Q p A CITY: �,� ZII'CODE: <br /> OWNER I OPERATOR: TELEPHONE: (La —) 5—6 <br /> - 3;7,fo <br /> PROGRAM ELEMENT: "►l.�'�� PROGRAM RECORD: Pn O )l ECTIO SPECT BY: <br /> V V # Code Section Pumper Trucks/Yards <br /> 1 DEV 9-1110.8; VALID PERMIT/REGISTRATION <br /> HSC 117405 <br /> DEV 9-1110.8; <br /> 2 HSC 117435 MONTHLY PUMPING REPORTS <br /> IDENTIFICATION OF VEHICLES: <br /> 3 CSDS(5) a)3":NAME,ADDRESS AND <br /> CAPACITY p <br /> b)6":REGISTRATION NUMBER <br /> TANK: <br /> HSC 117420 a)METAL CONSTRUCTION <br /> 4 CSDS(9)(A) b)LEAK PROOF VALVES <br /> C)MANUAL VALVES <br /> d)VALVE LOCATION <br /> HSC 117420 PUw' <br /> 5 CSDS(9)(B) FREE OF LEAKAGE,SPILLAGE OR <br /> SPLASHING. <br /> HOSES: <br /> HSC 11 <br /> 6 CSDS 17420 7420 a)AVAILABLE AND ADEQUATE. <br /> b)CLEAN AND WATERTIGHT. <br /> 7 HSC 117420; RACKS ARE MADE OF METAL <br /> CSDS(9)(D) <br /> 8 HSC 117420 YARD: <br /> CSDS(3) a)SANITARY AND ADEQUATE. <br /> CHEMICAL TOILETS <br /> 1 OWDS 11.5 TANK CAPACITY(40 GALLON MIN.) <br /> 2 OWDS 11.10 STORAGE SITE <br /> 3 OWDS 11.7 DISPOSAL SITE <br /> 4 OWDS 11.6 TYPE OF CHEMICALS <br /> 5 OWDS 11.8 UNSANITARY CONDmoN <br /> 6 OWDS 11.4 DOORS SELF-CLOSE,LOCKABLE <br /> 7 OWDS 11.2 VECTOR PROOF <br /> 8 OWDS 11.3 SURFACES SMOOTH/EASILY CLEAN <br /> 9 OWDS 11.1 FLOOR W/URINAL 10 SQ.FT. <br /> OWDS 11.1 FLOOR W/OUT URINAL 8 SQ.FT. <br /> 10 OWDS 11.1 SUFFICIENT CE. <br /> 11 OWDS 11.9 LETTE IGHT 3" <br /> RECEIVED BY: Ti DATE: <br /> REHS: PHONE:I_ I^- ?J O W7, DATE: �L s <br /> V=Violation;RV=Repeated Violation SEE REVISE SIDE FOR ADDITIONAL A <br /> AL INFFORMTIONPAGE:I OF_ <br /> Revised on 11/22/2021 U:\Unit-IRLiquid Waste\Form-Pumper Trucks Official Inspection Report-ffNAL.doc <br />