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SAN JOAOUIN COUNTY 00 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. S''a 2'l I`� Phone(209)468-3420 <br /> PERMIT NO. 00 81�f 9 <br /> STR. OPER. DBA Inspectron row <br /> POULTRY RANCH 4 4OA-0 f&& A}rJG // Z Cj&- <br /> WATER WELL Premise Address Recheck Date <br /> -- 1. WELL CONSTRUCTION 3 O I,o 3G E C06 471E�0- A-f t A/ <br /> - - 2. CROSS-CONNECTION :J <br /> MANURE MANAGEMENT <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> � . <br /> - - 3. SPREADING AND D19CING 1��t VOL% t,J I <br /> - - 4. CONCRETE TANKS <br /> -- 5. LAGOONING <br /> - - 6. COMPOSTING C <br /> O*�k.yp D C � q ►`e!1 <br /> BIRD DISPOSAL <br /> - - 7. BURYING WITH 2'OF COVER W t K d ry w _ Q l/ , o -�/ b t-�c oC nor- <br /> 8. APPROVED CONCRETE TANK <br /> -- 9. REMOVAL FROM PREMISES /ye c..t 40 L4.,&of f-v%AJ O r lt p- y)ti B*t u r•2 01K r%eec✓ <br /> VECTOR CONTROL � <br /> - - 10. DOMESTIC FLY Au of Ope Ear'Ct�is� <br /> - - 11. FANNIA FLY 1 <br /> - - 12. LARVAE �Qr E✓r�✓I.�o o r lC a T ✓Vl 7 Y u re i1•t t X�Gid Gu. <br /> - - 13. PUPAE Q rQ 2y. .r1.t Gi vt b 1 /Q <br /> - - 14. ADULT <br /> - - 15. LIGHT POPULATION ✓uQ S[D�I S tir2-rt D�.�P /yPG/ <br /> - - 16. MODERATE POPULATION <br /> - - 17. HEAVY POPULATION <br /> FEEDING/WATER <br /> - - <br /> 18. WATER TROUGHS CD/ --ryi►u0 d'4 qC fL ✓x T tom¢ /--g'k-A r" r O -"c Q <br /> - 19. CUPS OR BOWLS <br /> - - 20. FOOD STORAGE L.71'�y1'i4'"`� kr'f vt�e c c v'11c � '4a, <br /> HOUSES Inge A u-0- /C nQ t2 ` r.wa C4 A."r•[ r Id, � <br /> - - 21. FLOORS <br /> -- 22. WALLS/CEILINGS C�i a I e.� .Hn"tiGaPtet 1 �, r K Go r,Y D rra d t <br /> v <br /> - - 23. CLEANING FREQUENCY �R P W ��✓ � 'T" 4 ,-,a <br /> STR. OPER. `Z -7-2x t�/PS`+Qr� _d,rf r 'M'd r8 'e' d 4f <br /> KENNEL / A - <br /> WATER WELL tw.vtnl_�ra�2(c. S.D.vaL7/ ca.tct ct/So@� ♦.�'fT7 /tee <br /> -- 1. WELL CONSTRUCTION <br /> - - 2. CROSS CONNECTION SO r f <br /> FLOORS <br /> - - 3. PROPERLY GRADED TO SEWER 1 �( <br /> - - 4. DRAIN <br /> -- 5. SMOOTH/CLEANABLE ti o`/ 1C - rK t r.p MiIO►t K v� S r <br /> - _ 6. COVING t•� Tnp C rNk DD S�r�e G2 rz �vt• r` a �2t vl <br /> -- 7. CLEANING FREQUENCY <br /> WALLS w• tn.f t11 Let-Pc f-t Ca✓,Oor4deo/ <br /> - - 8. SMOOTH/CLEANABLE r�r,L d rvt,J Q ILO/ /o r ��,� ,•� r h r�G AIL- <br /> 9.- - CLEANING FREQUENCY /� <br /> CAGES s�6/ 4,e .L4o � o0 4 r //�6��� au,A4 - <br /> - - 10. CONDITION <br /> -- 11. SANITATION <br /> FOOD <br /> - - 12. STORAGE <br /> -- 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL <br /> - - 14. REMOVAL FROM PREMISES <br /> - - <br /> 15. OTHER <br /> SEWAGE DISPOSAL <br /> - - 16. SEPTIC SYSTEM <br /> - - 17. SEWER <br /> RABIES VACCINATION <br /> CERT �Spl <br /> 18. CERTIFICATE ON PREMISES Inealth ecialist Recei ed By <br /> 0 EH 07-01(690) <br />