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SAN JO, I COUNTY <br /> PUBLIC"�iAL SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON,CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> Phone(209)4683420 <br /> COMPUTER NO. <br /> PERMIT NO. ®^°® <br /> STR. OPER. DOA Inspections Date <br /> POULTRY RANCH a ( S / <br /> WATER WELL Premise Addhess heck Dale <br /> 1. WELL CONSTRUCTION <br /> 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST Bg CORRECTED: <br /> MANURE EMENT <br /> 3. SPREADING AND DIKING <br /> 4. CONCRETE TANKS <br /> 5. LAGOONING <br /> 6. COMPOSTING <br /> BIRD DISPOSAL <br /> 7. BURYING WITH 2'OF COVER q l <br /> _e 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 <br /> _ 20. FOOD STORAGE <br /> HOUSES <br /> 21. FLOORS <br /> 22. WALLS/CEILINGS <br /> _ 23. CLEANING FREQUENCY <br /> STH. 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 /> S. SMOOTH/CLEANABLE <br /> ®_ 6. COVING <br /> 7. CLEANING FREQUENCY 6t <br /> WALLS <br /> 8. SMOOTH/CLEANABLE <br /> _ 9. CLEANING FREQUENCY <br /> CAGES <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 /> RABIEBVACCINIATION <br /> _- 18. CERTIFICATE ON PREMISES SAf0TXAIAN ORECOVED B <br /> 0 EH 07-09(6AO) <br />