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SAN JOAQUIN COUNTY 0 <br /> 2 y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> 4�h9i . Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PT"0001000 VECTOR CONTROL INSPECTION FORM <br /> DBA / INS E <br /> Structure_ Operation c <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-INSPECTION DATE <br /> 11 El2. Cross-Connection 1 r-JC+ f <br /> Structure Operation Manure Management OWNER/OPERATOR HO <br /> ❑ ❑ 1 3. Spreading and Disking ® 905),36a <br /> ❑ ❑ 4. Concrete TanksIMwne <br /> TYPE PROGRAM ELEM NT R ECORDID <br /> ❑ 5. Lagoonin14 101 (10 <br /> ❑ ❑ 6. Compo ng The items below represent code violations and must be corrected: <br /> Structure Operation Bird Di osal <br /> ❑ ❑ 7. Bu ing with 2"of over <br /> ❑ ❑ 8. roved Concrete Tank e <br /> ❑ F19. emovai from Premises % i� 0e� <br /> Structure Operation actor Control <br /> ❑ ❑ 10. Domestic Fly 1 0 u <br /> 11. Fannia FI <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae " <br /> 1114. Adult 'e ` - ox OD04- <br /> 0 15. Li ht Population ` t <br /> ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population t <br /> structure peration Feeding/Water21) Floorsi1 1 V\ 67 000( <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cu s or Bowls e pepouj- AA's made, <br /> 0 El 20. Food Storage <br /> Structure Operation Houses ItI V ® I Y\ t,Q.( rt <br /> ❑ ❑ 21. Floors <br /> ❑ 22. WallsCeilins11 t r- r <br /> V) <br /> ❑ <br /> 23. Cleanini Fr uenc Th <br /> Structure Operation Water Well Jto <br /> ❑ El 1nstruction "f w S <br /> 2. s Connection �^ <br /> Structure Operation FlOM l e ®® <br /> ❑ ❑ I C_EwpoyGraded to Sewer <br /> ❑ ❑ m �c- swgfem. <br /> ❑ ❑ 5.igRiCleanable1 <br /> 9 ® S -e hd 0 <br /> ❑ ning Frequency <br /> � e . <br /> Structure Operation Walls <br /> ❑ /Cleanable �y < /� <br /> El ❑ 9 eanin Frequency q 0-C — <br /> structure Operation Cages <br /> ❑ ❑ ndition <br /> El 1:1 Sanitation <br /> Structure Operation F ydQjD <br /> ❑ ❑ 12. torn e <br /> Insect/Vermin 0 <br /> Structure Operation Animal Dis oral <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Ser ISpOS81 <br /> ❑ tem <br /> ❑ IF ❑ 17. Sewer a & <br /> Structure Oper3tlon Ra atlOn I ED BY INSPEC <br /> ❑ ❑ Ce ' on Premises <br /> VECTOR CONTROL INSPEC N FORM <br /> EHD 40-06 12/04/08 <br /> Page—of_ <br />