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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON,CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)468-3420 <br /> PERMIT NO. 4/30 <br /> M. OPER. DBA Inspection Date <br /> POULTRY RANCH - S"4&& ?-0 b )� <br /> WATER WELL Premise Address Recheck Date <br /> 1. WELL CONSTRUCTION <br /> 2. CROSS-CONNECTION <br /> MANURE MANAGEMENT THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: <br /> 3. SPREADING AND DICCING <br /> 4. CONCRETE TANKS <br /> _ 5. LAGOONING <br /> 6. COMPOSTING . <br /> BIRO DISPOSAL <br /> 7. BURYING WITH 2'OF COVER <br /> S. APPROVED CONCRETE TANK <br /> _^ 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> 10. DOMESTIC FLY <br /> 11. FANNIA FLY - s = "-A ve( i <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 /> STN. APER. <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 /> 5. SMOOTH/CLEANABLE <br /> 6. COVING <br /> 7. CLEANING FREQUENCY <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 /> RABIES VACCINATION <br /> -- 18.CERTIFICATE ON PREMISES SA RIAN ECEIV BY <br /> � EH 0741 pa9o) <br />