Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Vel 4 <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> <<FORa p® p� <br /> VECTOR® CONT INSPECTION FORM <br /> DB ; INSPECTION D TE <br /> Structure Operation % / , <br /> El El1. Well Construction PREMISE ADDRESS RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection Q/77K <br /> Structure Operation Manure Mana eme t OWNERIOPERATOR P ONE <br /> ❑ ❑ 3. Spreading and Di ing t_e I-1c 763 <br /> ❑ ❑ 4. Concrete Tank INSPECTION TYPE '2LZ PROGRAM ELEMENT RECORD ID <br /> 1:1 E] 5. Lagooning c -5'-1/ V4.4wis <br /> ❑ ❑ 6. Composting( The items below represent code violations and must be corrected: <br /> Structure Operation Bird DispO a) <br /> ❑ ❑ 7. Bu in ith 2"of Cover ✓ <br /> ❑ ❑ 8. Appried Concrete Tank <br /> ❑ ❑ 9. Re oval from Premises <br /> Structure Operation vegfor Control V 47 <br /> ❑ ❑ 1 Domestic FI <br /> El El 1. Fannia FI <br /> ❑ ❑ 12. Larvae / t7t+ <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ QK 15. Light Population <br /> ❑ 16. Moderate Population <br /> ev- <br /> 1:1 Ape4- <br /> 17. HeavyPopulation <br /> Structure10n Feeding/Water <br /> ❑ 1 ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cups or Bowls 4' <br /> 20. Food Storage <br /> Struc re Operation Houses <br /> ❑ 21. Floors <br /> ❑ ❑ 22. Walls/CeilingsXV-0,0" <br /> ❑ ❑ 1 23. Cleanin Fre uenc <br /> Structure Operation Water Well <br /> ❑ ❑ . Well Construction r <br /> 2. Cross Connection <br /> Structure Operation Floors l <br /> 3. Properly Graded to Sewer <br /> ❑ ❑ Vt4. Drain t" C <br /> ❑ ❑ 5. Smooth/Cleanable <br /> El El 6. Covin ele ' <br /> El 0 7. Cleaning Frequency <br /> Structure Operation Walls <br /> ❑ ❑ . Smooth/Cleanable <br /> ❑ ❑ 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 0. Condition <br /> 11 11. Sanitation <br /> Structure Operation Food <br /> ❑ ❑ 12. Storage <br /> 13. Insect/Vermin <br /> Structure Operation Animal Disposal <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination R CEI INSPEC OR _ <br /> ❑ ❑ 18. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 4/6/12 <br /> Page_of <br />