Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> _ - -. ENVIRONMENTAL HEALTH DEPARTMENT <br /> F. 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> �q. _-..•;P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �/PORN p® �g p� <br /> VECTOR® CONTROL INSPECTION FORM <br /> DBAINSPECTI N DA E <br /> Structure Operation o f -7/140 <br /> /3 <br /> ❑ ❑ 1. Well ConstructionPREMIISE ADDRESS RE-INSPECTION DATE <br /> 1:1 EI2. Cross-Connection J <br /> Structure Operation Manure Management/ OWNERIOPERATOR PRONE <br /> 13 3. Spreading and Diski g 7, eizzzltz_ <br /> 036' _ y,?,ef <br /> ❑ ❑ 4. Concrete Tanks INSPECTION TYPE VPROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning d/4/ GAY d)tf <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with °of Cover 6 <br /> ❑ ❑ 8. Approved oncrete Tank <br /> ❑ ❑ 9. Removal rom Premises <br /> Structure Operation Vector C ntrol <br /> ❑ ❑ 10. Do stir FI <br /> 11. Fa nia FI 1 <br /> ❑ ❑ 12. rvae 'i / '~ <br /> ❑ ❑ 13. u ae <br /> ❑ ❑ 1 . Adult <br /> ❑ ❑ 5. Light Population <br /> ❑ ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operat' n Feeding/Water <br /> ❑ 18. Water Trou hs <br /> ❑ 19. Cups or Bowls z ` ✓' <br /> El 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 1 21. Floors <br /> ❑ 22. Walls/Ceilings <br /> ❑ 23. Cleaning Frequency <br /> Structure Operation at@f w <br /> ❑ ❑ ell Construction ZileW ®� <br /> El t-A 2. Cross Connection <br /> Structure Operatio Flo <br /> El n Pro erl Graded to Sewer <br /> ❑ ❑ Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> 6. Covin <br /> 7. Cleaning Frequency <br /> Structure Operation all <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 9. Cleaning Frequency <br /> Structure Operatio ag `� <br /> 11 E] 10. Condition [o 1 <br /> El 0 11. Sanitation <br /> Structure Operation od <br /> ❑ ❑ fora e <br /> 3. Insect/Vermin <br /> Structure Operation nima)Disposal <br /> ❑ ❑ emo m Premises <br /> ❑ ❑ <br /> Structure Operationswage DISpOSB <br /> ❑ ❑ e tic S stem <br /> ❑ ❑ 7. Sewer <br /> Structure Operatio abies Vaccination REC ED BY INSP O <br /> ❑ ❑ i icate on Premises AVINYZ -,,3 ' <br /> VECTOR CONTROL INSPECTION FORM 77 <br /> EHD 40-06 4/6/12 Page of <br />