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SAN JOAQUIN COUNTY <br /> y` <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. �'(Zyy OC)L)1> Phone(209)468-3420 <br /> PERMIT NO. i I fy C7 <br /> STIR. OPER. 0BA ` Inspection Dale <br /> POULTRY RANCH <br /> WATER WELL Premise Address Recheck Date - <br /> - - 1. WELL CONSTRUCTION <br /> -- 2. CROSS-CONNECTION is <br /> MANURE MANAGEMENT THE ITEMS BELOW REPRES6dT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> 3. SPREADING AND DIGGING u,-k IV\V- t✓a. Q C C le?V` L's�-At -QJ, <br /> I -- CONCRETE TANKS <br /> 5. LA <br /> 6. COMPOSTING <br /> BIRD DISPOSAL ` <br /> - - 7. BURYING WITH 2'OF COVER <br /> - - 8. APPROVED CONCRETE TANK \ <br /> - 9. REMOVAL FROM PREMISES <br /> EC <br /> t VTOR CONTROL <br /> f r1 l C� s �.r 12 l e CA WN :r <br /> - - 10. DOMESTIC FLY Cd e ► t <br />{ _ - 11. FANNIA FLY <br /> iI 12. LARVAE <br /> -_ 13. PUPAE !! <br /> -_ <br /> 15" <br /> ,.LIGHT POPULATION , I � � � Y <br /> S <br /> _ 16. MODERATE POPULATION <br /> -_ 17. HEAVY POPULATION <br /> FEEDIN�/WATER <br /> 18. WATER TROUGHS �^ -4elk �o �� *�ff� �z(( G M <br /> 19. CUPS OR BOWLS t� I`ny` d t 1 F o; <br /> 10. FOOD STORAGE C.•.� 1A_ <br /> HOUSES <br /> -- 21. FLOORS (i <br /> 22. WALLS/CEILINGS �t'.<' CA 11 e <br /> -- 23. CLEANING FREQUENCY <br /> N <br /> STR. OPER. <br /> KENNEL (' - <br /> WATER WELL a �- yd u 4F_5 <br /> -_ 1. WELL CONSTRUCTION 1 <br /> - 2. CROSS CONNECTION c,V^e <br /> FLOORS <br /> _= 3. PROPERLY GRADED TO SEWER <br /> 4. DRAIN c�P C 40t \a l '�Vb7�\tIV1 f C' -:,.►.etS t1n e. <br /> _- S. SMOOTH/CLEANABLE c.. <br /> _- 6. COVING Olt P V' <br /> -- 7. CLEANING FREQUENCY <br /> WALLS / <br /> _ - 8. SMOOTH/CLEANABLE a / s e-:9'Cb e r <br /> AWj <br /> - 9. CLEANING FREQUENCY 44 <br />` CAGES <br /> fE4 10. CONDITION <br /> - 11. SANITATION <br /> FOOD ` L <br />� 12. STORAGE <br /> -_ 13. INSECT/VERMIN __�f) �+ �l t`, i �yr`I{�7j%� ✓ ,I'�L /7 <br /> ANIMAL DISPOSAL f ,� <br /> 14. REMOVAL FROM PREMISES �O <br /> 15. OTHER <br /> I <br /> SEWAGE DISPOSAL <br /> 16. SEPTIC SYSTEM <br />,¢ 17. SEWER <br /> C RABIES VACCINATWN a <br /> 18.CERTIFICATE ON PREMISES <br /> _.Aar ! _ - <br /> I Ehvironmental Health Specialist Received By <br /> _ql 07-01(6-60) _ - <br />