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19 SAN JOAQUIN COUNTY 46 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> yf VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)4683420 <br /> PERMIT NO. ff 0L <br /> STR. OPER. DBA Inspection <br /> ')- Inspection Date <br /> POULTRY RANCH "�' r � �iC�- / f CJ <br /> WATER WELL Premise Address Recheck Date <br /> - - 1. WELL CONSTRUCTION = cJG <br /> -- 2. CROSS-CONNECTION <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> MANURE MANAGEMENT <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 <br /> 20. FOOD STORAGE <br /> HOUSES <br /> - _ 21. FLOORS <br /> -- 22. WALLS/CEILINGS <br /> - - 23. CLEANING FREQUENCY <br /> STA. OPER. <br /> KENNEL <br /> WATER WELL ;a <br /> 1. WELL CONSTRUCTION <br /> - _ 2. CROSS CONNECTION ( <br /> FLOORS <br /> -- 3. PROPERLY GRADED TO SEWER <br /> _ 4. DRAIN r <br /> - - <br /> S. SMOOTH/CLEANABLE I � <br /> 6. COVING <br /> -- 7. CLEANING FREQUENCY � �/,C,;- all i <br /> WALLS (� F- � „Z <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 /r <br /> RABIES VACCINATION <br /> -- 18. CERTIFICATE ON PREMISES 4 <br /> RECEIVED BY �� <br />