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i►` <br /> SAN JOAQUIN COUNTY <br /> r �y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> •c� :. ;�• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �rFO <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA , INSPECTION DATE <br /> Structure Operation ® /� /J <br /> ❑ ❑ 1. Well Construction f PREMISE ADDRESS RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection 4-475:2 <br /> Structure Operation Manure Manag2pont OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and .king / _ zz <br /> ❑ ❑ 4. Concrete Tan IN ECTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning j/ ay -023 <br /> ❑ ❑ 6. Compostin The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disp I <br /> ❑ ❑ 7. Bu in with 2-of Cover <br /> ❑ ❑ 8. Appro4ed Concrete Tank <br /> ❑ ❑ 9. Re oval from Premises <br /> Structure Operation Vec r Control <br /> ❑ ❑ 10. Domestic FI <br /> El Li 1 t. Fannia FI <br /> ❑ ❑ 2. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ ❑ 15. Li ht Population <br /> ❑ EY 16. Moderate Population <br /> t <br /> ❑ 17. eavy Population <br /> Structure o enation Feeding/Water <br /> ❑ ❑ 18. Water Trou hs <br /> ❑ ❑ 19. Cups or Bowls <br /> 20. Food Storage_ <br /> re Operation Houses <br /> 01 <br /> ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleaning Frequency � <br /> ,,-, <br /> Structure Operation ater Wel <br /> ❑ ❑ 1. ell Construction <br /> 2. Connection <br /> Structure Operation IDorS <br /> ®' <br /> ❑ ❑ -3-15-ropedy-3-15-ropedGraded to Sewer <br /> ❑ ❑ . Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ 6. Covin ° <br /> 0 F1 7. Cleaning Frequency <br /> Structure Operation al S <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ . Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ ondition <br /> anitation <br /> Structure Operation i FOtid <br /> ❑ ❑ Lora e <br /> 11 13. Ins <br /> Structure Operation -Animal Dis oral <br /> ❑ ❑ emoval from Premises <br /> ❑ 15. her <br /> StructureOperation a e DISpOS <br /> ❑ ❑ 16. Septic S to <br /> ❑ ❑ 1 er <br /> Structure Operbtion hies Vaccination R Y` IN R <br /> ❑ ❑ remises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12IOM08 <br /> Page_of <br />