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SAN JOAQUIN COUNTY <br /> E RONMENTAL HEALTH DEPARTMWT <br /> 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 /> LIQUID WASTE OFFICIAL INSPECTION REPORT <br /> S=Structure 0=Ope <br /> S O Package Sewage Plant NAME OF FACILITY INSPECTION DATE <br /> 1. rease Trap <br /> 2.LiftTu-mp PREMISE ADDRESS REINSPECTION DATE <br /> 3.Fence Locked <br /> 4.Cross Connection <br /> 5.Odor The items below present health code violations and must be corrected: <br /> 6.Vectors ` <br /> 7. Soil Erosion <br /> 8.Blower Aerator <br /> 9.Skimmers Clarification <br /> 10.Aerator-Color <br /> 11.Sludge Return <br /> 12,Effluent Clarity <br /> 13.Polish Ponds <br /> 14.Excess Sludge <br /> 15.Sludge Bed <br /> 16.Weeds <br /> 17.Distribution Box <br /> 18.Water Level Pits _ <br /> 19.SoundingTube 1 C 't/�� / d� <br /> 20.Intermittent Dosing <br /> 21.Hazard Unsanit2g Condition <br /> 22. Yard/Equipment Maintenance <br /> 23.Failure Evident <br /> 24.Monitoring Report <br /> 25.Monitoring Well '-<�/ <br /> S 0 Chemical Toilets <br /> 1.Tank Ca a ityGiC cLL��1 <br /> 2. Storage Site / <br /> 3.Disposal Site <br /> 4.T e of Chemicals <br /> 5. Unsanit Condition -A <br /> 6.Doors Self Close/Locking�} �y <br /> 7.Vector Proof r °C�'71J� �� lal <br /> 8. Surfaces STnootb/Easily Clean <br /> 9.Floor w/Urinal 10 sq.ft. <br /> Floor w/oUrinal 8 sq.ft. <br /> 10.Additional Area Inside Hand Washin <br /> 11.Lettering Height 3" <br /> S O Pumper TruckslYards <br /> 1.Valid Permit/Registration _ <br /> 2.PumpinR Records <br /> 3.Lettering: <br /> Name(3"),Address(3"),Capacity 3" <br /> Registration Number(6") <br /> 4.Truck Tank: <br /> Metal Construction - <br /> Leak Proof Valves <br /> Manual Valves <br /> Valve Location <br /> 5.Pumps Sealed _ <br /> 6.Hoses: <br /> Pump Hose Adequate PROGRAM ELEMENT: PROGRAM RECORD: <br /> Cleaning Hose Adequate <br /> 7.Racks-Metal Aj -RECEIVED BY: -DATE: <br /> 8.Yard Sanitation: ANAC3 00 <br /> Sanitary <br /> R.E.H. DATE-. <br /> Adequate ! <br /> EHD 42-02-DD6 <br /> 3/1012005 <br />