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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON,CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)468-3420 <br /> PERMIT NO. <br /> STR. OPER. DBA Inspection Date <br /> POULTRY RANCH � 1/- a-67/ <br /> WATER WELLPremise Address Recheck Date <br /> ✓ 1. WELL CONSTRUCTION 30636 <br /> �D 3 E <br /> -- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT _ <br /> _ 3. SPREADING AND DICCING U wll� g <br /> 7 Z 3 alvl rl"6-6 ai1l x_34, 060 <br /> _ 4. CONCRETE TANKS At <br /> 5. LAGOONING 1`Q Vi D lab 011 arA u nI4 - <br /> -_U"6. COMPOSTING .- <br /> S- baA&:; Duck.- uny-rrlat��h <br /> BIRD DISPOSAL <br /> - _ 7. BURYING WITH 2'OF COVER _L46 R ?4A rV la 16-AU 4- 0!d (dam <br /> rL <br /> -- 8. APPROVED CONCRETE TANK �- <br /> _ - 9. REMOVAL FROM PREMISES <br /> VECTOR 590TROL w <br /> 1/10. DOMESTIC FLYli ld / <br /> - _1 11. FANNIA FLY a`L <br /> - _ 12. LARVAE ` / ! <br /> - - 13. PUPAE ~ IOU, •� <br /> _4,-W. ADULT <br /> - LIGHT POPULATION <br /> _- 16. MODERATE POPULATION <br /> -- 17. HEAVY POPULATION O <br /> FEEDING/WATERke r <br /> _ 18. WATER TROUGHS llS / ✓�� s <br /> 19. CUPS OR BOWLS c /'��/r-pw- dant n p 6 k*- r 16 q,3 a 1 <br /> 20. FOOD STORAGE _ <br /> HOUSES ' D � <br /> -- 21. FLOORS <br /> 22. WALLS/CEILINGS <br /> - _ 23. CLEANING FREQUENCY <br /> dw <br /> SIR. OPER. <br /> KENNEL <br /> WATER WELL <br /> -_ 1. WELL CONSTRUCTION <br /> - - 2. CROSS CONNECTION <br /> FLOORS <br /> 3. PROPERLY GRADED TO SEWER <br /> 4. DRAIN <br /> 5. SMOOTH/CLEANABLE <br /> - - 6. COVING <br /> -- 7. CLEANING FREQUENCY <br /> WALLS <br /> _ 8. SMOOTH/CLEANABLE <br /> 9. CLEANING FREQUENCY <br /> CAGES <br /> - _ 10. CONDITION <br /> 11. SANITATION <br /> FOOD <br /> 12. STORAGE <br /> -_ 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL <br /> - _ 14. REMOVAL FROM PREMISES <br /> - _ 15. OTHER <br /> SEWAGE DISPOSAL <br /> - _ 16. SEPTIC SYSTEM <br /> _ 17. SEWER /7 <br /> RABIES VACCINATION C ✓ y�� ,�� <br /> _- 18. CERTIFICATE ON PREMISES SANITARIAN R EIVED BY <br /> 0 EH 07-01(600) <br /> L_ <br />