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QyxrN c a..r SAN JOAQUIN COUNTY <br /> 3•��'A <br /> ENVIRONMENTAL HEALTH DEPARTM !KT <br /> s 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 /> �{trFbRwt <br /> LIQUID WASTE OFFICIAL INSPECTION REPORT <br /> S=StructurePeration T^ <br /> S O Package Sewage Pt NAME OF FACILITY INSPECTION DATE <br /> 1. rease Trap Z� 111-1C.G /-/-X "Q7- <br /> 2,Lt PREMISE ADDRESS �s REINSPECTION DATE <br /> 3,Fence Locked <br /> 4.Cross Connection The items below present health code violations and must be corrected: <br /> 5.Odor <br /> 6.Vectors �.� <br /> 7. Soil Erosion %'Jl/Q <br /> 8.Blower Aerator <br /> 9. Skimmers Clarification S <br /> 10.Aerator-Color <br /> 11.Sludge Return e- ,:Z5 <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.Sounding Tube �-L 40e2ga <br /> 20,Intermittent Dosing _ <br /> 21.Hazard Unsanita Condition < e !ir <br /> 22.Yard/Equipment Maintenance <br /> 23.Failure Evident <br /> 24,Monitoring Report <br /> 25.Monitoring Well <br /> S O Chemical Toilets <br /> 1.Tank Capacity <br /> 2.Storage Site <br /> 3.DisiZal Site <br /> 4.Type of Chemicals <br /> 5. Unsanitary Condition /C� 00 - <br /> 6.Doors Self Close/Locking <br /> 7.Vector Proof <br /> 8.Surfaces Smooth/Easily Clean <br /> 9.Floor w/Urinal 10 sq.ft. <br /> Floor w/oUrinal 8 sq.ft. <br /> 10.Additional Area Inside Hand Washing /�� /D(/l-Z��s�� <br /> 11.Lettering Height 3" <br /> S O Pum er Trucks/Yards <br /> 1.Valid Permit/Registration <br /> 2.Pumping Records <br /> 3.Lettering: <br /> Name 3" ,Address(3"),Capacity 3" <br /> Re istration 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: OGRAM RECORD: <br /> Cleaning Hose Adequate <br /> 7.Racks-Metal ECEIVEb BY: DATE: <br /> 8.Yard Sanitation: !/ CJ <br /> Sanitary R.E.H. DATE: <br /> Adequate <br /> EHD 42-02-006 <br /> 3110/2005 <br />