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SAN JOAQUIN COUNTY 40 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. / 2.Sr00�1� Phone(209)468-3420 <br /> PERMIT NO. <br /> Ow NFA +!S IC.L KcIM.�J 6- <br /> STIR. OPER. <br /> DBA Inspection Date <br /> POULTRY RANCH �b• itf2' QA-02-7--G-4 RZ4tiCy /'U 4 C? <br /> WATER WELL Premise Address Recheck ate <br /> -- 1. WELL CONSTRUCTION 3o I NG"fan/ <br /> -- 2. CROSS-CONNECTION <br /> OL- <br /> M"RE MANAGEMENT THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> - - 3. SPREADING AND DIKING <br /> EI/ <br /> ("O DI/093 f"--cetV�ed CfLa.r,t Qrylabt.ti"1� D`r���l�S <br /> - - 4. CONCRETE TANKS <br /> - - LAGOONING <br /> / � ► K // ft //�� <br /> V � t ¢� Q Ia'�& <br /> . COMPOSTING <br /> BIRD DISPOSAL O aot-(I 1C--S wGt rtio( r lit Co�++.00l'/ <br /> - - 7. BURYING WITH 2'OF COVER a,,,e_y Q K- i w ko-',u5-1 <br /> - - 8. APPROVED CONCRETE TANK <br /> - - 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL / / �S S• (p / <br /> - - 10. DOMESTIC FLY �i <br /> rI _� '^� I^�« 1 w� 07 'cc Ott <br /> - - 11. FANNIA FLY <br /> - - 12. LARVAE t, <br /> Vtt$C S �t�1 1 3 f!T - <br /> - - 13. PUPAE S ,E W r n�(e v p�x d>-�/�-•S^ -dt 1/ it rk.1 0-f- <br /> 14. ADULT <br /> --_ 15. LIGHT POPULATION Mat- r0 rrkd - y7T:!4n tit&e 1'Ced, <br /> -- 16. MODERATE POPULATION <br /> - - 17. HEAVY POPULATION <br /> FEEDING/WATER L <br /> - - 18. WATER TROUGHS OVt.ra(I 4 �a r4C O°� �G�t oas�t� « `Fltt S c_,G_$ OJ&C/veo( <br /> - 19. CUPS OR BOWLS / <br /> - - 20. FOOD STORAGE 1•. Q if o s4 t r.{ a -e.< a r Loi �l otter' s "` S a d <br /> I I _Cv y <br /> HOUSES �Q 41-y 07 -f p l .S ax-L-h.w Twp C tM.,D b S/ ftt✓n 2� r vG+�{ <br /> -- 21. FLOORS <br /> -- 22. WALLS/CEILINGS ale "9Q (A- rbcoSSO o/ IO 0r rn OT W4 W I tiouwW <br /> - - 23. CLEANING FREQUENCY <br /> I� +P l d O t S-ore 4d a n Cl <br /> STR. OPER. p( fSCQ ot QS SeVK a f a6� <br /> oSSre <br /> KENNEL - <br /> WATER IELL <br /> WELL CONSTRUCTI � �/� " r I / <br /> - - \3. ROPERLY <br /> ONNECTION Mprti /J(/y�p� ` TK nAL *,, fJsAd Skal/ k-o aC,4,,cjtd 'f o A,,y0k <br /> FLOORS �� <br /> - - GRAD D TO SEWER ",Izo-►-FaCLEA ABLEG F EQUENCY IF <br /> S nQOr Qo <br /> WALLS <br /> - - 8. SMOOTH/ L ANABLE /� rf r+�S LRC77„�. Wr�I Cot`cCu G1/-�� e• ay -ev /Q�/`�F8 <br /> - - 9. CLEAN GF QUENCY <br /> CAGES <br /> - - 10. CON (TION <br /> - - 11. SA ITATION <br /> FOOD <br /> - - 12. TORAGE <br /> -- 13. INSECT/VERMIN <br /> ANIMAL DI OSAL <br /> - _- 4. REMOVAL FROM PREMISES <br /> - - 15. OTHER <br /> SEWAGE ISPOSAL <br /> - - 16. SEPTIC SYSTEM <br /> - - 17. SEWER <br /> RABIES VACCINATION <br /> -- 18. CERTIFICATE ON PREMISES <br /> nvironmentaal He <br /> a <br /> lth Specialist Recei ed By <br /> 49 EM 07-01 <br />