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SANdOAQUIN Environmental Health Department <br /> C O U N T Y <br /> gCrFOR� Greatness grows here. <br /> PUMPER TRUCKSNARDS & CHEMICAL TOILETS OFFICIAL INSPECTION REPORT <br /> NAME OF FACILITY: INSPECTION DATE: d 72- <br /> PREMISE ADDRESS: CITY: L ZIP CODE: <br /> Z!) <br /> OWNER/OPERATOR: TELEPH NE: r <br /> PROGRAM ELEMENT: PROGRAM RE RD: INSPECTION TYPE: REINSPECT BY: <br /> V RV # Code Pumper TrucksNards FTheems below present health code violations and must be corrected: <br /> Section <br /> 1 SJC 9-1110.8; VALID PERMIT/REGISTRATION �� Y <br /> HSC 117405 (( <br /> 2 SJC 9-1110.8; MONTHLY PUMPING REPORTS L <br /> HSC 117435 <br /> 3 SJLDR(5) IDENTIFICATION OF VEHICLES: <br /> a)3 INCH:NAME,ADDRESS AND CAPACITY ` <br /> b)6INCH:REGISTRATION NUMBER <br /> TANK: <br /> HSC 117420 <br /> 4 a)METAL CONSTRUCTION <br /> SJLDR(9)(A) b)LEAK PROOF VALVES <br /> C)MANUAL VALVES <br /> d VALVE LOCATION <br /> HSC 117420 <br /> 5 PUMP: <br /> SJLDR(9)(B) NO LEAKAGE,SPILLAGE OR SPLASHING. <br /> HSC 117420 HOSES: (i <br /> 6 a)AVAILABLE AND ADEQUATE. <br /> SJLDR b)CLEAN AND WATERTIGHT. <br /> 7 HSC 1177420;420; METAL RACKS I Ci <br /> SJLDR(9)(D) <br /> 8 HSC 117420 YARD: <br /> SJLDR(3) SANITARY AND ADEQUATE. {/ <br /> i Mtn f-1 I(-Aj <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 CONDITION <br /> 6 OWDS 11.4 DOORS SELF-CLOSING,LOCKABLE <br /> 7 OWDS 11.2 VECTOR PROOF <br /> 8 OWDS 11.3 SURFACES SMOOTH/EASY TO CLEAN <br /> 9 OWDS 11.1 FLOOR AREA W/URINAL(10 SO.FT.) <br /> OWDS 11.1 FLOOR AREA W/OUT URINAL(8 SO.FT.) <br /> 10 OWDS 11.1 SUFFICIENT SPACE. <br /> 11 OWDS 11.9 LETTERING HEIGHT 3 <br /> ,>QHES Uri <br /> RECEIVED BY: TITLE: ^r L. DATE: I y Z L <br /> RENS: . PHONE: "T DATE: <br /> V=Violation; RV=Repeated Violation SEE REVERSE SIDE FOR ADDITIOrJAL INFORMA ION !� PAGE:1�O/F(/ <br /> EHD 42-020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />