Laserfiche WebLink
P°"°" SAN JOAQUIN COUNTY <br /> o , c <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �P <br /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RANCH DBA ��¢ INSPE TIO DATE <br /> Structure Operation Water Well To\ <br /> ❑ ❑ 1. Well Construction PR MISE ADDRESS REINSPECTI N DATE <br /> ❑ ❑ 2. Cross-Connection -C 9 t <br /> Structure Operation Manure Management OWNER/OPE TOR PHON <br /> ❑ ❑ 3. Spreading and Disking w <br /> ❑ ❑ 4. Concrete Tanks INSP CTION TY;E PROGRAM LEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning Q <br /> ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"ofCover <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises kA <br /> Structure Operation vector Control <br /> ❑ ❑ 10. Domestic FI <br /> ❑ ❑ 11. Fannia FI `-- <br /> ❑ 12. Larvae O <br /> ❑ 13. Pupae ..- <br /> ❑ El 14. Adult ® O 5 P\- <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population ® T <br /> ❑ 17. Heavy Population ty <br /> Structure Operation Feeding/Water 1. <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cups or Bowls ., C'_Lt <br /> x V, O S <br /> ❑ 20. Food Storage `f <br /> Structure Operation Houses �. v\ \ <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings ® C mei <br /> ❑ ❑ 23. Cleanin Frequenc <br /> KENNEL l9 � <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> ❑ ❑ 2. Cross Connection P <br /> x <br /> Structure Operation Floors <br /> ❑ 3. Properly Graded to <br /> ❑ ❑ 4. Drain L D L o <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Coving t c� <br /> ❑ ❑ 7. Cleaning Frequency C <br /> Structure Operation Walls G P <br /> ( ❑ ❑ 8. Smooth/Cleanable <br /> ❑ 9. Cleaning Frequency O c A ` l J <br /> Structure Operation Cages <br /> ❑ 10. Condition <br /> ❑ ❑ 11. Sanitation <br /> Structure Operation Food <br /> ❑ 0 12. Storage <br /> El ❑ 13. Insect/Vermin C <br /> Structure Operation Animal Disposal <br /> ❑ ❑ 14. Removal from Premises" <br /> 15. Other <br /> Structure Operation Sewage Disposal <br /> 11 ❑ 16. Septic System <br /> ❑ El 17. Sewer <br /> Structure Operation Rabies Vaccination _ R IVED AE=k <br /> 0 El18. Certificate on Premises <br /> EHD 40-06 6/30/2005 Page_of_ <br />