Laserfiche WebLink
*SAN JOAQUIN COUNTY <br /> ` •.Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �(ROR <br /> VECTOR CONTROL INSPECTION FORM <br /> DBAINSPECTION DATE <br /> Structure Operation3,1140 <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-1 SPEC N DATE <br /> ❑ ❑ 2. Cross-Connection <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking Z -® , <br /> ❑ ❑ 4. Concrete Tanks INSPECTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ 5. Lagooning T <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 1 7. Burying with 2"of Cover <br /> ❑ ❑ 8. Aoproved Concrete Tank <br /> ❑ ❑ e * r es <br /> Structure Operation Vector Control <br /> ❑ ❑ 10. Domestic FI <br /> 11. Fannia FI <br /> ❑ ❑ 12. Larvae Q <br /> ❑ ❑ 1 13. Pupae <br /> ❑ ❑ 14. Adult &Z2 .S'< <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑ ❑ 18. WaterTroughs <br /> El El19. Cups or Bowls <br /> 20. Food Storage <br /> structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleanin Fr uenc <br /> structure operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> 2. Cross Connectio <br /> St ture Operation Floors <br /> ❑ 3. Properly Grad to Sewer <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/ anable <br /> ❑ 6. Covin <br /> 7. CIean6 Frequency <br /> Structure O ration Walls rax- <br /> 1:1 8. S ooth/Cleanable <br /> ❑ ❑ 9.hleaning Frequency <br /> Structure Operatio ages <br /> ❑ ❑ 10. Condition <br /> 11 1. Sanitation <br /> Structure Operatio od <br /> ❑ ❑ 12. Stora e <br /> 13. sect/Vermin <br /> Structure Op tion Ani 1 Disposal <br /> ❑ ❑ 14. Re vaI from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Dkposal <br /> ❑ ❑ 16. Septic S <br /> ❑ 17. Sewer <br /> S cture Oper9tion Rabies Vaccinat n RECEIVED INSPEC OR <br /> ❑ ❑ 18. Certificate on Premises IUA <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page_of f <br />