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0p4 W.C' SAN JOAQUIN COUNTY <br /> Q: <br /> ti ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: 1868 E Hazelton Ave, Stockton,CA 95205 <br /> • c P Telephone:(209)468-3420 Fax:(209)464-0138 Weh:www.sjgov.org/ehd <br /> 9�rFOR� <br /> PUMPER TRUCKSIYARDS & CHEMICAL TOILETS <br /> OFFICIAL INSPECTION REPORT <br /> NAME OF FACILITY: s r l+ NI``C S INSPECTION DATE: OZZ <br /> PREMISE ADDRESS: t �C/ CITY: Awk ZIP CODE: <br /> OWNER/OPERATOR: UTELEPHONE: Z� � <br /> < t th <br /> PROGRAM ELEMENT: Y-1 PROGRAM RECORD: 9° INSPECTION TYPE: i1 REINSPECT BY: <br /> `IZS3"' lvwn:ad o ST•!1�9� L� <br /> V v # Code Section Pumper Trucks/Yards Dh book's � <br /> I DEV 9-1110.8; VALID PERMIT/REGISTRATION <br /> HSC 117405 n <br /> 2 DEV 9-1110.8; MONTHLY PUMPING REPORTS <br /> HSC 117435 <br /> IDENTIFICATION OF VEHICLES: <br /> 3 CSDS(5) a)3":NAME,ADDRESS AND i 11✓\ G V o <br /> CAPACITY <br /> b)6":REGISTRATION NUMBER <br /> TANK: <br /> HSC 117420 a)METAL CONSTRUCTIONDw40 a/ 0 a t '4f ✓L <br /> 4 b)LEAK PROOF VALVES <br /> CSDS(9)(A) C)MANUAL VALVES <br /> d)VALVE LOCATION IT nIGJY d , <br /> HSC 117420 Pte' �h l t c ti r� �� G ✓ --yon 4 oe1e,-.k t <br /> 5 CSDS(9)(B) FREE OF LEAKAGE,SPILLAGE OR <br /> SPLASHING. <br /> HSC 117420 HOSES: <br /> 6 CSDS(9)(C) a)AVAILABLE AND ADEQUATE. <br /> b)CLEAN AND WATERTIGHT. <br /> 7 HSC 117420; RACKS ARE MADE OF METAL <br /> CSDS(9)(D) ©(,d „ 1 t. / 6,r- <br /> 8 <br /> ia8 HSC 117420 YARD: 'd r t 4� <br /> CSDS(3) a)SANITARY AND ADEQUATE. <br /> CHEMICAL ToELETS Couyef4y <br /> 1 OWDS 11.5 TANK CAPACITY(40 GALLON MIN.) 64,11h �c3 <br /> 2 OWDS 11.10 STORAGE SITE <br /> 3 OWDS 11.7 DISPOSAL SITE kz.l c n t <br /> 4 OWDS 11.6 TYPE OF CHEMICALS <br /> 5 OWDS 11.8 UNSANITARY CONDITION <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 /> to OWDS 11.1 SUFFICIENT SPACE. <br /> 11 OWDS 11.9 LETTERING HEIGHT 3" <br /> RECEIVED BY: TITLE:G DATE. zaLz <br /> INSPECTED BY: l , PHONE: DATE: <br /> S ` io — 2 2v- <br /> V=Violation;RV=Repeated Violation SEE REVISE SIDE FOR ADDITIONAL INFORMATION PAGE:1 OF_ <br /> Revised on 1/13/2022 P:\scanned\Unit 2\Francisco\Form-Pumper Trucks Official Inspection Report-fINAL.doc <br />