Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> r =� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �F OR <br /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RANCH DB INSPECTION DATE <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction PREMIE DRESS RE SPECTION DATE <br /> ❑ ❑ 2. Cross-Connectio <br /> Structure Aeration Manure Manage ent OWNERIOPERATOR PHONE p <br /> ❑ ❑ 3. Spreading an Disking 4-Tic,-Y-6 6-C> 3 I <br /> ❑ 4. Concrete T nks INSPECTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ 5. Lagooni ' <br /> ❑ ❑ 6. comp ting The items below represent code violations and must be corrected: <br /> Structure operat;o Bird DV posal <br /> ❑ ❑ 7. B in with 2"ofCover <br /> ❑ 11 8. pproved Concrete Tank <br /> 11 [1 Removal from Premises <br /> Structure Operation Actor Control / <br /> El 10. Domestic Fl l IP r <br /> 11 El1 i. Xannia Fl // <br /> El [112. Arvae l / <br /> El Ey 13. Pu ae <br /> , <br /> ❑ 14. Adu t 1.1/t <br /> \10❑ ❑ 15. Li ht o ulation <br /> ❑ ❑ 16. Mode to Population gr4,2 e_> c) C>j 91%.41 <br /> ❑ 17. Heavy ulation <br /> Structur Operation Feeding/Wa r JeZl2d e2a-- <br /> 11 18. Water Tro hs <br /> 11 19. Cu s or Bo Is <br /> ❑ 20. Food Stora e <br /> ructure Operation Houses 1 �� <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilin s <br /> ❑ ❑ 23. Cleanin Fre uenc <br /> KENNEL a lJ k-ay- <br /> Structure Operation Water Well <br /> ❑ I. Well Construction <br /> El ❑ 2. Cross Connection <br /> Structure Operation Floors <br /> d9a C'- <br /> El ❑ 3. Properly Graded to <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Covin 1 f <br /> ❑ 0 7. Cleanin Fre uenc <br /> Structure Operation Walls <br /> ❑ ❑ 8. Smooth/Cleanable r <br /> ❑ ❑ 9. Cleaning Frequency , <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> ❑ El 11. Sanitation Bit <br /> Structure Operation Food !.%vCZA <br /> ❑ 0 12. Storage <br /> ❑ ❑ 13. Insect/Vermin <br /> Structure Operation Animal Disposal <br /> 4 <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure operation Sewage Disposal <br /> stem❑❑ El 16. Septic System- <br /> 0 <br /> ❑ 17. Sewer <br /> StruMnre operation Rabies LVaccination - TRi IN E <br /> ❑ 18. Cen Premises <br /> EHD 40-06 6/30/2005 Page of t <br />