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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTIONFORM <br /> COMPUTER NO. L Phone(209)468-3420 <br /> PERMIT NO. ID20()iocv <br /> sTR. OPER. <br /> DBA inspection Date . <br /> POULTRY RANCH a �` t _ <br /> WATER WELL Premise'Address Recheck Date <br /> _ 1. WELL CONSTRUCTION <br /> 2. CROSS-CONNECTION <br /> MANURE MANAGEMENT THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> 3. SPREADING AND DICCING <br /> 4. CONCRETE TANKS <br /> 5. LAGOONING <br /> 6. COMPOSTING <br /> BIRD DISPOSAL <br /> 7. BURYING WITH 2'OF COVER <br /> 8. APPROVED CONCRETE TANK <br /> 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> 10. DOMESTIC FLY <br /> 11. FANNIA FLY <br /> 12. LARVAE <br /> 13. PUPAE <br /> 14. ADULT <br /> 15. LIGHT POPULATION <br /> 16. MODERATE POPULATION <br /> 17. HEAVY POPULATION <br /> FEEDING/WATER <br /> ® 18. WATER TROUGHS ) � - <br /> 19. CUPS OR BOWLS 1 <br /> 20. FOOD STORAGE <br /> HOUSES <br /> 21. FLOORS <br /> 22. WALLS/CEILINGS <br /> _ s 23. CLEANING FREQUENCY <br /> STR. OPER. <br /> KENNEL <br /> WATER WELL <br /> 1. WELL CONSTRUCTION <br /> 2. CROSS CONNECTION <br /> FLOORS <br /> 3. PROPERLY GRADED TO SEWER <br /> _ 4. DRAIN <br /> 5. SMOOTH/CLEANABLE <br /> _ 6. COVING <br /> __ 7. CLEANING FREQUENCY <br /> WALLS <br /> 8. SMOOTH/CLEANABLE <br /> _ 9. CLEANING FREQUENCY <br /> CAGES <br /> X10. CONDITION <br /> 11. SANITATION <br /> FOOD <br /> 12. STORAGE <br /> _ ® 13. INSECT/VERMIN <br /> ANIMAL DI OSAL <br /> 14. REMOVAL FROM PREMISES <br /> __ 15. OTHER <br /> SEWAGE DISPOSAL <br /> 16.,SEPTIC SYSTEM <br /> 17. SEWER ; <br /> RABIES VA b <br /> ili <br /> -- 18CERTIFICATE ON PREMISES <br /> SA IAN RECElvgb BY <br /> I EH 07-01(840) r <br /> Lo <br />