Laserfiche WebLink
at`au'k c SAN JOAQUIN COUNTY <br /> �2 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> •..::•N�� Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> /FOR <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA � INSPECTION DATE <br /> Structure Operation Water Well <br /> 11 111. Well Construction PREMISE ADDRESS RE-1SPECTION DATE <br /> ❑ ❑ 2. Cross-Connectiont1 <br /> Structure operation Manure Management OW ER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking - .. <br /> ❑ ❑ 4. Concrete Tanks INSPEC ON TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning r s-- <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises f <br /> Structure Operation Vector control <br /> ❑ ❑ 10. Domestic FI <br /> 11. Fannia FI <br /> 1:1 1112. Larvae ' ( `L CIAJ <br /> 11 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cu s or BoWs <br /> 20. Food Storage <br /> structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleanin Fr uenc <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction R <br /> ❑ 2. Cross Connection <br /> Structure Operation Floors 4 ' <br /> ❑ ❑ 3. Proper) Graded to Sewer <br /> ❑ e- ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> 6. Covin <br /> 7. Cleaning Fre uen <br /> Structure Operation Walls ' <br /> ❑ j14. ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 9. Cleaning Frequency <br /> Structure Operation Cages <br /> 11:1 <br /> ❑ 10. Condition11. Sanitation <br /> Operation Food <br /> ❑ 12. Stora e <br /> 13. Insect/Vemtin <br /> Operation Animal Dis oral <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination RECEIVED B INSPECTO <br /> ❑ ❑ 18. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page_of_ <br />