COMPLIANCE INFO_2009-2016 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT { 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <<F ORN ® �® p® VECTOR CONT INSPECTION FORM DBA INSPEC ION DATE Structure Operation Water Well 10 :7115 ❑ ❑ 1. Well Construction PREMISE ADDRESS 95-2 �� RE-INSPECTION DATE 1:1 El 2. Cross-Connection J Structure Operation Manure Management OWNER/OPERATOR PHONE ❑ ❑ 3. Spreading and Disking oxwtro- 1® _'yS-g 6'74 ❑ ❑ 4. Concrete Tanks INSPECTION TYPE PROGRAM ELEMENT RECORD ID ❑ ❑ 5. Lagooning PIZO Ljoc D x-12 ❑ ❑ 6. Composting The items below represent code violations and must be corrected: Structure Operation Bird Disposal ❑ ❑ 7. Burying with 2"of Cover QL 6 u ❑ ❑ 8. Approved Concrete Tank 0 ❑ ❑ 9. Removal from Premises Structure Operation Vector Control ❑ ❑ 10. Domestic FI 13 0 11. Fannia FI s ❑ ❑ 12. Larvae (Iii ❑ ❑ 13. Pupae ❑ ❑ 14. Adult ❑ ❑ 15. Light Population ❑ ❑ 16. Moderate Population ❑ ❑ 17. Heavy Population Structure Operation Feeding/Water ❑ ❑ 18. Water Trou hs ❑ ❑ 19. Cups or Bowls 20. Food Storage Structure Operation Houses ❑ ❑ 21. Floors ❑ ❑ 22. Walls/Ceilings ❑ ❑ 1 23. Cleanin Fre i uenc Structure Operation Water Well ❑ ❑ 1. Well Construction 2. Cross Connection Structure Operation Floors El 0 3. Pro erl Graded to Sewer ❑ ❑ 4. Drain ❑ ❑ 5. Smooth/Cleanable 1:1 El 6. Covin El El 7. Cleanina Frequency Structure Operation Walls ❑ ❑ 8. Smooth/Cleanable ❑ ❑ 9. Cleaning Frequency Structure Operation Cages ❑ ❑ 10. Condition El 11. Sanitation Structure Operation Food ❑ ❑ 12. Storage 13. Insect/Vermin Structure Operation Animal Disposal ❑ ❑ 14. Removal from Premises ❑ ❑ 15. Other Structure Operation Sewage Disposal ❑ ❑ 1 16. Septic System ❑ ❑ 17. Sewer Structure Operation Rabies Vaccination RECEIVED BY INSPECTOR ❑ ❑ 18. Certificate on Premises m t VECTOR CONTROL INSPECTION FORM EHD 40-06 4/6/12 Page of_