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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON,CA 95202 <br /> VECTOR CONTROL INSPECTIONFORM <br /> COMPUTER NO. Phone(209)468-3420 <br /> PERMIT NO. <br /> STIR. OPER. DBA Inspection Date <br /> POULTRY RANCH f~I.kZ' -//' <br /> WATER WELL Premise Address Recheck Date <br /> -_ 1. WELL CONSTRUCTION 7 CT <br /> -- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENf CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT <br /> -- 3. SPREADING AND D19CING <br /> -- 4. CONCRETE TANKS cc <br /> -- 5. LAGOONING <br /> -- 6. COMPOSTING <br /> �,b � Ltd - �r✓t>'t�� �, cJ <br /> BIRD DISPOSAL <br /> - _ 7. BURYING WITH r OF COVER <br /> 8. APPROVED CONCRETE TANK <br /> -- 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL Zc� <br /> - - 10. DOMESTIC FLY <br /> - - 11. FANNIA FLY 'Di? r F-D 3 8[ f ub $<, <br /> 12. LARVAE 1 <br /> 13. PUPAE <br /> 14. ADULT <br /> -- 15. LIGHT POPULATION <br /> 16. MODERATE POPULATION <br /> 17. HEAVY POPULATION <br /> FEEDING/WATER <br /> -- 18. WATER TROUGHS <br /> _- 19. CUPS OR BOWLS <br /> - - 20. FOOD STORAGE <br /> HOUSES <br /> 21. FLOORS <br /> -- 22. 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. SMOOTH/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 /> -- <br /> 16.,SEPTIC SYSTEM <br /> - - 17. SEWER <br /> RABIES VACCINATION 'V"�- <br /> -- 18. CERTIFICATE ON PREMISES <br /> SANITA IAN RtCEIVED BY <br /> 0 EH 07-01(440) <br />