Laserfiche WebLink
o�qul" SAN JOAQUIN COUNTY <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> coq..- .;.,:•;�• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �rFOR� <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA t� INSPECTION DATE <br /> Structure Operation "5 �( R y f /S///, <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection C) Q f!liL>r <br /> ki <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking CZO-1 9 ai3'-)Y/ <br /> ❑ ❑ 4. Concrete Tanks INSPECTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning l,C S 2 w J <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover j <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises <br /> Structure Operation Vector Control <br /> ❑ ❑ 10. Domestic Fly3 r- <br /> ❑ ❑ 11. Fannia FI <br /> ❑ ❑ 12. Larvae - <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 1 14. Adult <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population $', <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water S <br /> ❑ ❑ 18. WaterTrou hs <br /> E] El ""r� <br /> 19. Cups or Bowls Yl &U <br /> ❑ ❑ 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleanin Fre uenc <br /> stn, re Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> ❑ 2. Cross Connectio <br /> Structure Operation Floors <br /> ❑ ❑ 3. Properly Grad to Sewer <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/ eanabie <br /> ❑ KI 6. Covin <br /> ❑ 11 7. Cleanog Frequency <br /> Structure Operat n Walls/ it <br /> ❑ ❑ 8. S Doth/Cleanable <br /> ❑ ❑ 9. leaning Frequency <br /> Structure Operation ges <br /> ❑ ❑ Condition <br /> 11. Sanitation <br /> Structure Operation' Food <br /> ❑ ❑ s' 12. S rae <br /> El D 13. Ins cWermin - <br /> Structure Ope6tion Animal is osal <br /> ❑ ❑ 14. Remov from Premises 1/td s <br /> ❑ is ❑ 15. Other IF <br /> Structure Operation Sewage Dis osal <br /> ❑ ? ❑ 16. Septic Sto <br /> ❑ 17. Sewer <br /> S cture Operation Rabies Vaccination RECEIVED INSPECT R <br /> d � <br /> ❑ ❑ 18. Certificate on Premises x <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page_of f <br />