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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-2708 <br /> rP Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PUMPER TRUCKS/YARDS & CHEMICAL TOILETS <br /> OFFICIAL INSPECTION REPORT <br /> NAME OF FACILITY: INSPECTION DATE: L <br /> PREMISE ADDRESS: *1z c.Q� �►A CITY: 5�`,4.n i p ZIP CODE: <br /> OWNER/OPERATOR: . � � TELEPHO 2C c - g 7 <br /> PROGRAM ELEMENT: PROGRAM RECORD: INSPECTION TYPE: REINSPECT BY: J <br /> V V # Code Section Pumper Trucks/Yards F- <br /> C) <br /> DEv 9-1110.8; VALID PERMIT/REGISTRATION 1AA <br /> HSC 1174052DEV 9-1110.8; MONTHLY PUMPING REPORTS <br /> HSC 117435 IDENTIFICATION OF VEHICLES:3 CSDS(5) a)3":NAME,ADDRESS AND <br /> CAPACITY <br /> b)6":REGISTRATION NUMBERTANK: <br /> HSC 117420 a)METAL CONSTRUCTION <br /> 4CSDS(9)(A) b)LEAKPROOF VALVES MANUAL VALVES O <br /> d)VALVE LOCATION <br /> HSC 117420 Puw' <br /> 5 CSDS(9)(B) FREE OF LEAKAGE,SPILLAGE OR ^ n y1 <br /> SPLASHING. <br /> HSC 117420 HOSES: <br /> 6 CSDS(9)(C) a)AVAILABLE AND ADEQUATE. � c, <br /> b)CLEAN AND WATERTIGHT. <br /> 7 HSC 117420; RACKS ARE MADE OF METAL <br /> CSDS(9)(D) <br /> 8 HSC 117420 YARD: d �Q <br /> CSDS(3) a)SANITARY AND ADEQUATE. <br /> CHENucAL 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 CONDITION Q n <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 S CIENT SPACE. <br /> 11 OWDS 11.9 TTERING IIT 3" <br /> RECEIVED BY: TITLE' DAT <br /> RENS: PHONE: <br /> V=Violation;RV=Repeated Violation SEE REVISE SIDE FOR ADDITIONAL INFORMATION PAGE:1 OF_ <br /> Revised on 11/22/2021 U:\Unit-MLiquid Waste\Form-Pumper Trucks Official Inspection Report-IINAL.doc <br />