Laserfiche WebLink
q <br /> *SAN JOAQUIN COUNTY <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �fFORI� ® ®� ® ® p� <br /> VECTOR CONTROL INSPECTION FORM <br /> DBAa INSPECTION DATE <br /> Structure Operation 1 f j 2 ft! <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection 39/ <br /> Structure Operation Manure Management OWNER/OPERATOR° PHONE <br /> ❑ ❑ 3. Spreading and Disking 6f- Lt37T$ <br /> ❑ ❑ 4. Concrete Tanks INS N TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ 5. Lagooning /J� g q O / <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover j <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises ` <br /> Structure Operation Vector Control <br /> ❑ ❑ 10. Domestic FI <br /> 11. Fannia FI <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult /< ! <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population i@ " <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑11 j ❑ 18. Water Troughs <br /> 11 ❑ 19. Cups or Bowls f/ <br /> 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ALe4j�44- <br /> El I ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cieanin Fr uencEm <br /> p <br /> t <br /> Stricture Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> ❑ 0 2. Cross Connection <br /> Structure Operation Floors <br /> ❑ ❑ 3. Properly Graded to Sewer <br /> ❑ ❑ 4. Drain <br /> ElC- ❑ 5. Smooth/Cleanable <br /> 6. Covin <br /> 7. CleaningFrequency <br /> Structure Operation I Walls ,S <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> 11. Sanitation <br /> Structure Operation Food (071 aLA <br /> ❑ ❑ 12. Storage <br /> 13. insect/Vermin <br /> Structure Operation Animal Disposal <br /> El El14. Removal from Premises t4 <br /> ❑ ❑ 15. Other <br /> StructureL�pperation Sewage Disposal <br /> ❑ 16. Se tic S tem <br /> ❑ 17. Sewer04Structure Rabies Vaccination R Y INSPECTOR <br /> ❑ 18. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page Of 1 <br />