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SAN JOAQUIN COUNTY 16 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)4683420 <br /> PERMIT NO. <br /> STR. OPER. DBA Inspection ate <br /> POULTRY RANCH L�/��`Ri ( (GA N U ? /3 <br /> WATER WELL Premise Address Recheck Date <br /> -- 1. WELL CONSTRUCTION .2.0137 F- "E two ,e t moo...) <br /> -- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT it <br /> 3. <br /> -- 3. SPREADING AND D19CING C o4�.,� Q t.[f n2L es[t�G C.Gi c�S c n. '( t tit t0 r�b(1�►K tl <br /> -- 4. CONCRETE TANKS <br /> _- 5. LAGOONING <br /> - - 6. COMPOSTING <br /> BIRD DISPOSAL � /�E `� cncduo`�Gd Qs �elLrWs <br /> - - 7. BURYING WITH 2'OF COVER <br /> 8. APPROVED CONCRETE TANK <br /> 9. REMOVAL FROM PREMISES Li/t tc.CJ2.. fl�CS - �!FeQ..� V e w[ 1e�1-Elt `f 1c., Y�r`4QcQI.+r <br /> VECTOR CONTROL ^ /� <br /> -- 10. DOMESTIC FLY <br /> -- 11. FANNIA FLY �} <br /> - - 12. LARVAE ✓ -� c rod rvt 4!ti iA CPQ - `F�[N J/`QpLt!c ho 6 vlre.cQ c <br /> _- 13. PUPAE d�Q d 6t raGS rt.l4o <br /> 14. ADULT <br /> 515. LIGHT POPULATION <br /> [/ 16. MODERATE POPULATION <br /> -- 17. HEAVY POPULATION <br /> FEEDING/WATER <br /> clti24tur@S Si�l1 1 _ �Gat� - <br /> -- 18. WATER TROUGHS <br /> - 19. CUPS OR BOWLS <br /> -- 20. FOOD STORAGE / /} <br /> HOUSES Lta_G2.S 4;- Ct.d cc.!* /l���t . <br /> _- 21. FLOORS // r- <br /> -_ 22. WALLS/CEILINGS ( i�[.��Qcr.. vac,w�4v kzA"'-.2 <br /> -- 23. CLEANING FREQUENCY r / <br /> AS <br /> STR. OPER. M Q[;,4A[ 1 l�s cM. �d 6c rol Cc -a <br /> -a <br /> KENNEL �-+ / <br /> WATER WELL '] D✓arw e�D - e ut✓dS G e[vy�a��N CLGGeL wa etl�G� <br /> -- 1. WELL CONSTRUCTION <br /> - - 2. CROSS CONNECTION (+ A" <br /> FLOORS <br /> -- 3. PROPERLY GRADED TO SEWER <br /> -- 4. DRAIN t/ Q/17�O,L✓ IC Q elf Q S't E E �S d't)1M_4� ✓off-sem . <br /> 5. SMOOTH/CLEANABLE -r <br /> - - 6. COVING <br /> -_ 7. CLEANING FREQUENCY /�� <br /> WALLS A Ito(rig d2 i 44- tcdt��� 41tiLtt. L., r4,C ,>kd aw D a <br /> - - 8. SMOOTH/CLEANABLE S�Ib/4ct <br /> 9. CLEANING FREQUENCY G <br /> CAGES <br /> -- 10. CONDITION <br /> -- 11. SANITATION <br /> FOOD <br /> -- 12. STORAGE <br /> -_ 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL <br /> 14. REMOVAL FROM PREMISES <br /> 15. OTHER <br /> SEWAGE DISPOSAL <br /> -- 16.,SEPTIC SYSTEM IN <br /> 17. SEWER <br /> RABIES VACCINATION <br /> -- 18. CERTIFICATE ON PREMISES SANITARIAN EIVED BY <br /> 0 EH 07-0+1^401 <br />