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r <br /> 0 SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, ST TON, CA 95202 <br /> VECTOR CONTROL INSPECTIONFORM <br /> COMPUTER NO. Phone <br /> PERMIT NO. <br /> DBA Itet''Date 9t <br /> STR. OPER. <br /> POULTRY RANCH <br /> WATER WELL Prem' Address Recheck Date <br /> 1. WELL CONSTRUCTIONLo di Sal w <br /> 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT DE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT <br /> 3. SPREADING AND DI9CING <br /> 4. CONCRETE TANKS <br /> 5. LAGOONING <br /> 6. COMPOSTING <br /> BIRO DISPOSAL <br /> 7. BURYING WITH 2'OF COVER <br /> 8. APPROVED CONCRETE TANK <br /> 9. RENAL FROM PREMISES ok Al" <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 8MLS <br /> 20. FOOD STORAGE <br /> HOUSES <br /> 21. FLOORS <br /> 22. WALLS/CEILINGS <br /> 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 /> _e 5. SMOOTH/CLEANABLE <br /> _ 6. COVING <br /> 7. CLEANING FREQUENCY <br /> WALLS <br /> 8. SMOOTH/CLEANABLE <br /> 9. CLEANING FREQUENCY <br /> GAGES <br /> _ 10. CONDITION <br /> 11. SANITATION <br /> FOOD <br /> 12. STORAGE <br /> 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL <br /> 14. REMOVAL FROM PREMISES <br /> _ 15. OTHER <br /> SEWAGE DISPOSAL <br /> 16.,SEPTIC SYSTEM <br /> _ 17. SEWER <br /> RABIES VACCINATION <br /> ® t8.CERTIFICATE ON PREMISES SANITARIAN C F D Y <br /> ® EH 07-09("M <br />