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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL EALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)468-3420 <br /> PERMIT NO. <br /> STR. OPER. DBA Inspection Date - <br /> POULTY RANCH catfir ra el <br /> WATER WELL Premise Addr Recheck Date <br /> ® 1. WELL CONSTRUCTION ( 1 <br /> ® 2. CROSS-CONNECTION1 <br /> MANURE NT <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST B CORRECTED: <br /> PSPREADING AND DIWCING <br /> 4. C RETE TANKS <br /> ® 5. LAGOONING CUM 9 <br /> ® 6. COMPOSTING <br /> BIRD DISPOSAL <br /> _ 7. BURYING WITH 2°OF COVER <br /> 8. APPROVED CONCRETE TANK <br /> ® 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> - , 10. DOMESTIC FLY <br /> ® � 11. FANNIA FLY <br /> 12. LARVAE <br /> 13. PUPAE <br /> 14. ADULT - <br /> 15. LIGHT POPULATION <br /> _® 16. MODERATE POPULATION a <br /> _e 17. HEAVY POPULATIONLAI <br /> FEEDING/WATER <br /> WATER TROUGHS <br /> 18. 0, mgjdA ho;ae <br /> CUPS OR BOWLS <br /> ® 20. FOOD STORAGE <br /> HOUSES Q <br /> 21. FLOORS <br /> . WALLS/CEILINGS <br /> 23. CLEANING FREQUENCY <br /> STR. 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. 0TH/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 <br /> RABIES VA F <br /> 18. CERTIFICATE ON PREMISES <br /> Envi Intal FYVea,lth Specialist -R ceived By <br /> 0 EH 07-11(8-90) <br />