Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> �o cOG <br /> Q, '? ENVIRONMENTAL HEALTH DEPARTNI T <br /> �, >< <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 /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RAN)CH DBA t INSPEC ION AT <br /> St ure Operation Water Wel t .l S t�-W-� "✓ t <br /> ❑ 1. Well Construction PREMISE ADDRESS <br /> f a REINS EC N DATE <br /> C1 El 2. Cros Connection 3`111 1 I �Cr <br /> d j_()0(f <br /> Structure Operation Manuo Management OWNER/OPERATOR PHONE Q <br /> ��nn r'`` 7 <br /> El ❑ 3. S eading and Disking Q,� J �lJs �V L � �° <br /> ❑ ❑ 4. Increte Tanks IPECTION TYPE PROGRAM ELEMENT RECORD ID (f�� <br /> 1:15. gooning t�, iAL 4 a O (fV <br /> ❑ N 6.Pomposting The items below represent code violations and must be corrected: <br /> Structure Opera'on B' d Disposal <br /> ❑ ❑ 7 Burying with 2"of Cover <br /> ❑ ❑ Approved Concrete Tank <br /> ❑ ❑ Removal from Premises " <br /> Structure Operation Vector Control 1 <br /> ❑ ❑ 0. Domestic Fly % cxv�x C&AL i� CA 61f�S, <br /> ❑ ❑ 1\. Fannia Fly q <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. ae <br /> ❑ ❑ 14. dull <br /> ❑ ❑ 15. 1- ht Population <br /> ❑ ❑ 16. Mo erste Population <br /> ❑ 17. Hea4 Population r, <br /> Structure Ope tion Feeding/ ater .I +Cye-'�) t <br /> ❑ 18. Water ou hs <br /> ❑ 19. Cups or kwls I <br /> ❑ ❑ 20. Food Stora e L <br /> Structure eration Houses L� 0 &II1 <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings ueI 1 <br /> 'w lmnae- <br /> ❑ 1 ❑ 23. Cleaning Frequency <br /> KENNEL <br /> Structure Operation Water Well nn <br /> 11 1:11. Well Construction r v, <br /> ❑ ❑ 2. Cross Connection , { e,p <br /> Structure Operation Floors ' J 1 "t- �' 1 <br /> ❑ ❑ 3. Properly Graded to 14 <br /> I t <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Covin <br /> ❑ ❑ 7. Cleaning Frequency 7p {,Joh <br /> Structure Operation Walls `� 0, ► l,V ',` <br /> 11 ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 9. Cleanin Fre uenc W / <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> ❑ ❑ 11. Sanitation f p ( .Q I <br /> Structure Operation Food l a° V fl.� all <br /> ❑ ❑ 12. Storage <br /> ❑ ❑ 13. InsectlVermin <br /> Structure operation Animal Disposal <br /> ❑ ❑ 14. Removal from Pr Mises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination RECE Y INS ECTOR <br /> ❑ ❑ 18. Certificate on Premises <br /> EHD 40-06 6/30/2005 IqPage-of <br />