Laserfiche WebLink
SAN JOAQUIN COUNTY 40 <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> �:,_; :NVQ • Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �rFOR <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA INSPECTION DATE <br /> Structure Operation <br /> ❑ ❑ 1. Well Construction PREMISE AiDDRESS RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection <br /> Stricture Operation Manure Mana a nt OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking j <br /> ❑ ❑ 4. Concrete Tan INSP CTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning 4 y,T9"" <br /> ❑ ❑ 6. Compostinj The items below represent code violations and must be corrected: <br /> Structure Operation Bird Dispgial P el- e- <br /> ❑ ❑ 7. Bu 'n with T'of Cover <br /> ❑ ❑ 8. ApprWved Concrete Tank WO <br /> ❑ ❑ 9. R oval from Premises ! <br /> Structure Operation Ve or Control <br /> ❑ ❑ 1 Domestic FI <br /> El El 1. Fannia FI <br /> 11 ❑ 12. Larvae 2c 2S"' <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult I C LLP, °S LMLIa& fL 1101 <br /> ❑ 15. Light Population <br /> ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water C <br /> ❑ ❑ 18. Water Troughs <br /> L❑ ❑ 19. Cups or Bowls <br /> 20. Food Storage <br /> S re Operation Houses S. C CS' LQ <br /> ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings ; ` ® RCe <br /> ❑ ❑ 1 23. Cleaning Fr uenc <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> El 0 2. Cross Connection <br /> Structure Operation Floors I • L4 <br /> ❑ ❑ 3. Properly Graded to Sewer <br /> ❑ 0 , 4. Drain : <br /> ❑ ❑ 5. Smooth/Cleanable I� <br /> 6. Covin - t s <br /> 7. Cleaning Frequency <br /> Structure Operation Walls CT <br /> a <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 1 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> 11. Sanitation <br /> Structure Operation Food t <br /> ❑ ❑ 12. Storage <br /> 13. Insect/Vermin <br /> Structure Operation Animal Dis Osal <br /> ❑ ❑ 14. Removal from Premises S <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination RECEIVE Y PECT <br /> ❑ ❑ 18. Certificate on Premises z " <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page ` of_ <br />