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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION P.O. BOX 2009, STOCKTON, CA 95202 VECTOR CONTROL INSPECTION FORM COMPUTER NO. Phone(209)468-3420 PERMIT NO. Z064�t-'-p- STR. OPER. DBA Inspecct�ion ate q POULTRY RANCH LQ � ` _ WATER WELL Prem se AddressL Rechec c Date _ 1. WELL CONSTRUCTION _ 0 2. CROSS-CONNECTION THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: MANURE MANAGEMENT _ _ 3. SPREADING AND DIKING Y. 4. CONCRETE TANKS-OIC _ 5. LAGOONING SDy, +6.e JA V tn'Aiers are 6. COMPOSTING BIRD DISPOSAL 7. BURYING WITH 2'OF COVER 8. APPROVED CONCRETE TANK -'b ! I _ 9. REMOVAL FROM PREMISES VECTOR CONTROL Li i � /� 1 10. DOMESTIC FLY D6�t.11 �((�b� D" t� �� _ 11. FANNIA FLY _ 12. LARVAE 13. PUPAE 1 C _ 14. ADULT J _ 15. LIGHT POPULATION _ 16. MODERATE POPULATION _ 17. HEAVY POPULATION r3) Seo arnu,tt d ekdW Lal LE�VILLUL�S (J .1l YI j6Q FEEDING/WATER y 18. WATER TROUGHS �v,,- �CDp LA)10- S ILA v 19. CUPS OR BOWLS D cr 20. FOOD STORAGE HOUSES _ 21. FLOORS r 6 lL 22. WALLS/CEILINGS 23. CLEANING FREQUENCY STR. OPER. KENNEL WATER WELL 1. WELL CONSTRUCTION 2. CROSS CONNECTION FLOORS 3. PROPERLY GRADED TO SEWER _ . DRAIN _ 5. SMOOTH/CLEANABLE _ 6. OVING 7. C EANING FREQUENCY WALLS _ 8. SMOO /CLEANABLE _ 9. CLEANI G FREQUENCY CAGES _ 10. CONDITION _ 11. SANITATION FOOD _ 12. STORAGE 13. INSECT/VERMIN ANIMAL DISPOSAL 14. REMOVAL FROM PREMISE 15. OTHER SEWAGE DISPOSAL 16. SEPTIC SYSTEM 17. SEWER RABIES VACCINATION - 18. CERTIFICATE ON PREMISES An,irohmen Hea th S 3' -i7r st Received By ® EH 07-M(6410)