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SAN JOATUIN 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 /> STR. OPER. DBA Inspection Date <br /> POULTRY RANCH <br /> WATER WELL Premise Address I Recheck Date <br /> -_ 1. WELL CONSTRUCTION <br /> _- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANUIRE MANAGEMENT <br /> 3. SPREADING AND DICCING <br /> -- 4. CONCRETE TANKS <br /> 5. LAGOONING mN <br /> 6. COMPOSTING <br /> BIRD DISPOSAL <br /> 7. BURYING WITH 2°OF COVER it ® k <br /> -- 8. APPROVED CONCRETE TANK <br /> 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> -- 10. DOMESTIC FLY ° C <br /> Lir <br /> 11. FANNIA FLY <br /> - - 12. LARVAE <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 /> S R. <br /> ~WATER WELL <br /> ®� 1. WELL CONSTRUCTION <br /> - e 2. CROSS CONNECTION <br /> Z,.,- <br /> FLOORS <br /> -- 3. PROPERLY WADED TO SEWER 0 <br /> -- 4. DRAIN <br /> 5. SMOOTH/CLEANABLE bK. <br /> -- 6. COVING <br /> - 7. CLEANING FREQUENCY <br /> WALLS <br /> _- 8. SMOOTH/CLEANABLE OK <br /> 9. CLEANING FREQUENCY O <br /> CAGES <br /> -- 10. CONDITION CK <br /> 11. SANITATION <br /> FOOD <br /> ®- 12. STORAGE <br /> ® 13. INSECT/VERMIN <br /> °ANIMAL DISPOSAL <br /> ® 14. REMOVAL FROM PREMISE <br /> ® 15. OTHER <br /> SEWAGE DISPOSAL <br /> 16.,SEPTIC SYSTEM <br /> 17. SEWER <br /> K- <br /> RAINESVACCINATWNe <br /> - 18.CERTIFICATE ON REMISES A TAR AN RECEIVED B <br /> ;EH 0741.(600) <br />