Laserfiche WebLink
ENRSAN JOAQUIN COUNTY <br /> ONMENTAL HEALTH EPARTM <br /> 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RANCH DBA IN PECTION DATE <br /> Structure Operation Water Well I 7 c' 9 IL <br /> ❑ ❑ 1. Well Construction PREMISE ADDR9SS REI SPECTION DATE <br /> ❑ ❑ 2. Cross-Connection 7r0 16c,, <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking ,` <br /> 333 CiLl 5: <br /> ❑ ❑ 1 4. Concrete Tanks INTYPE PROGRAM ELEMENT RECORD ID <br /> El El <br /> 5. <br /> 5. Lagooning , c Piz o <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 <br /> ❑ El8. Approved Concrete Tank L- <br /> ❑ ❑ 1 9. Removal from Premises <br /> Structure Operation Vector Control y <br /> ❑ 0 10. Domestic Fl <br /> ❑ ❑ 11. Fannia Fl <br /> r <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult t 5e-t'r% L')" " <br /> ❑ ❑ 15. Light Population , <br /> lation r7d^ n`3 e- <br /> ❑ 16. Moderate Pou1111 ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑ El 18. Water Troughs <br /> ❑ ❑ 19. Cu2s or Bowls `Zr <br /> ❑ ❑ 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> I <br /> ❑ 22. Walls/Ceilings 4,11iq -9` - ' <br /> ❑ ❑ 23. Cleanin Fre uenc <br /> K E N N E L L)0r� <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> 11 ❑ 2. Cross Connection <br /> Structure Operation Floors 1 ' <br /> ❑ ❑ 3. Properly Graded to (� / <br /> ❑ El 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Covin t <br /> ❑ 7. Cleaning Frequency <br /> Structure Operation Walls <br /> ❑ 0 8. Smooth/Cleanable <br /> 1:1 El 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition 1 <br /> ❑ ❑ 11. Sanitation <br /> Structure Operation Food <br /> 12. Storage <br /> ❑ El13. Insect/Vermin C ( <br /> Structure Operation Animal Disposal <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other ' <br /> Structure Operation Sewage Disposal E/t 0; o <br /> ❑ ❑ 16. Septic System <br /> 11 ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination RECEI D B INSPE <br /> ❑ ❑ 18. Certificate on Premises <br /> EHD 40-06 6/30/2005 Page_of <br />