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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. )PR 40//003( Phone(209)468-3420 <br /> PERMIT NO. Qo07 1 T <br /> STR. OPER. DBA Inspection Date <br /> POULTRY RANCH L�D•y( (GE AJAJIE774 K 4AJ t's- Sq Q- 2?3p 1 Z IE-/g8 <br /> WATER WELL Premise Address Recheck Date <br /> - - 1. WELL CONSTRUCTION 2-o i,3-7 E , ,-4,E4y-o ILD )e-!7�O0/✓ <br /> -- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT <br /> 3. SPREADING AND D19CING ted G•� µ, �/t Lj r Qp�.tet r rt �j 1.8 (�Q <br /> 4. CONCRETE TANKS <br /> -_ 5. LAGOONING wi <br /> - - 6. COMPOSTING <br /> BIRD DISPOSAL <br /> - - 7. BURYING WITH 2'OF COVER UL - G <br /> CI&;. r <br /> WrAfe- � AfeY /T <br /> 0.ae 4✓a,+,�r <br /> -- 8. APPROVED CONCRETE TANK Ag <br /> , <br /> - - 9. REMOVAL FROM PREMISES M r •�a r+t [la�.n.t tt t/i i 40 sop NQri ofyltiK.n.r t.'e .'►. k tS M41/u Kd'. <br /> VECTOR CONTROL y/ <br /> - - DOMESTIC FLY ie- <br /> 10. <br /> - - 11. FANNIA FLY <br /> - - 12. LARVAE <br /> -- 13. PUPAE / CA_ µ� ✓�� /! � ' <br /> -- 14. ADULT <br /> - - 15. LIGHT POPULATION L d 4e, •f / -t't. - L S G( wrl <br /> -- 16. MODERATE POPULATION <br /> -- 17. HEAVY POPULATION f Cu �r •� Q3 <br /> 7'n� GOyG-S N O _M ►..r w Q S 0C.0 Lt rte',.tet p eO <br /> FEEDING/WATER .1 �y <br /> - - 18. WATER TROUGHS C�''�iA10 d elit..✓N 47 0 gtg. S .De l�r• �Rn4 • <br /> 19. CUPS OR BOWLS L J _ <br /> - - =r:h <br /> 0 <br /> 20. FOOD STORAGE /C /l O T K/ r G L.t1d yrrro�S •' <br /> HOUSES ® /VD✓' -,�'C[o! QoliaC�,.� Ty P ccGGw I,tott�eS - Ol0 QKpose of <br /> _- 21. FLOORS <br /> -- 22. WALLS/CEILINGS dk-&y%C f M K.0 e- ✓S.n c 'f 1 GS <br /> _ - 23. CLEANING FREQUENCY <br /> l 71&o r1,f- •y-u rtictr� 4t wk - -u►o o-F�k I'-4P- w�¢_-�a/ 6le-C I. jg�dCa <br /> / . <br /> STR. OPER. /.Q T{t r rd /r d !S -to Jae /,sta l(ket late,-4,dal <br /> KENNEL IJ r k-WATER WELL lS A -+r.. ✓4 Q KA&h2-7'M - dV1 e o-1 -/-w O OA-2'f Gt /t elitC i.,„j&Ce, <br /> -- 1. WELL CONSTRUCTION <br /> - - 2. CROSS CONNECTION `/ke sr c.>'Ld ltd is -f o be 94.es <br /> FLOORS _ ,g <br /> -- 3. PROPERLY GRADED TO SEWER ay-y'^,/'d � a' " - , t t�1 wdlLd G -1-p at a'4 <br /> - - 4. DRAIN <br /> - - <br /> S. SMOOTH/CLEANABLE C/J <br /> 6. COVING <br /> -- 7. CLEANING FREQUENCY a ret G_t 1 <br /> IT 1� s�G K n-i6e a-,t a,4 <br /> t T� O� ct� �419ae <br /> WALLS 7)"a vTv�-� r.V t l f ✓P rt R, C�✓�1 q,1LG / �Q t�r C t^e 4t,� <br /> -- 8. SMOOTH/CLEANABLE <br /> -- 9. CLEANING FREQUENCY /r�- <br /> CAGES /'1'CIor�41 0" a <br /> - - 10. CONDITION <br /> -- 11. SANITATION <br /> FOOD ��[p� �Q.-, <br /> -- 12• STORAGE j`""" " ' `0(d /r__ r� WGS PIC SCOVGvGt� lSJ14•.e�� <br /> -_ 13. INSECT/VERMIN tI((t0( W.`l't'. wa4eK' 7-.01 CDyG^a-0f Wr•��• ��HwroCC PjDV/u-f- CL <br /> ANIMAL DISPOSAL <br /> - - 14. REMOVAL FROM PREMISES Stw•.ltc✓ l Coves✓ O✓ (l �It �C t r t"r t I` SOr l O✓ <br /> - _ 15. OTHER <br /> as Svvvi Gt.,f QafStvte <br /> SEWAGE DISPOSAL <br /> - _ 16. SEPTIC SYSTEM <br /> _ 17. SEWER <br /> RABIES VACCINATION <br /> -- 18. CERTIFICATE ON PREMISES SANITARIAN RECEIVED BY <br /> ® EH 07-01(8.00) - <br />