COMPLIANCE INFO_PRIOR TO 2018 - Laserfiche WebLink

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Pa"t" 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 ORa VECTOR CONTROL INSPECTION FORM DBA ® n ° INSPECTION DATE Structure Operation h ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-INSPECTION DATE ❑ ❑ 2. Cross-Connection ® V. Structure Operation Manure Management OWNER/OPERATOR PHONE ,�,� El El 3. Spreading and Disking ` C 2®9 33 37 ❑ ❑ 4. Concrete Tanks INSPECTION TYPE PROGRAM ELEMENT RECORD ID ❑ ❑ 5. Lagooning tJk`r 2 b®S ❑ ❑ 6. Composting The items below represent code violations and must be corrected: Structure Operation Bird Disposal ❑ ❑ 7. Burying with 2"of Cover ❑ ❑ 8. Approved Concrete Tank ❑ ❑ 9. Removal from Premises Q ' e Structure Operation vector Control ❑ ❑ 10. Domestic FI 11. Fannia FI ❑ ❑ 12. Larvae ® C� ❑ ❑ 13. Pupae ❑ ❑ 14. Adult ❑ ❑ 15. Light Population ❑ ❑ 16. Moderate Population ❑ ❑ 1 17. Heavy Population Structure Operation Feeding/Water ❑ ❑ 18. Water Troughs ❑ ❑ 19. cups or Bowls 20. Food Storage Structure Operation Houses ❑ ❑ 1 21. Floors ❑ ❑ 1 22. Walls/Ceilings ❑ ❑ 23. Cleaning Frequency Structure Operation Water Well ❑ ❑ 1. Well Construction El 2. Cross Connection Structure Operation Floors El 3. Properly Graded to Sewer ❑ ❑ 4. Drain ❑ ❑ 5. Smooth/Cleanable El El 6. Covin 7. Cleaning Frequency Structure Operation Walls ❑ ❑ 8. Smooth/Cleanable ❑ ❑ 9. Cleaning Frequency Structure Operation Cages ❑ ❑ 10. Condition 11. Sanitation Structure Operation Food ❑ ❑ 12. Storage. 11 El 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 VECTOR CONTROL INSPECTION FORM EHD 40-06 4/6/12 ' 2 Page_of