Laserfiche WebLink
®°Out"' c SAN JOAQUIN COUNTY <br /> r ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> Lo <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RANCH DBA INSPECTION DATE <br /> Structure Operation Water Well ' C- - 5- <br /> ❑ 1. Well Constructi PREMISE ADDRESS REINSPECTION DATE <br /> ❑ 2. Cross-Connec on <br /> Strucm Operation Manure Mana ement OWNERIOPERATOR PHONE <br /> ❑ ❑ 3. Spreadin nd Disking kA <br /> ❑ ❑ 4. Concre Tanks INSPECTION TYPEOGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lago ing ply (® �, 71+00�t <br /> p- Cs <br /> ❑ ❑ 6. Co osting The items below represent code violations and must be corrected: <br /> Structure O eration Bird fisposal <br /> ❑ 7. 96�ying with 2"of Cover <br /> ❑ 8.Approved Concrete Tank <br /> n <br /> ❑ 9/Removal from Premises <br /> Structure operat n ector Control <br /> ❑ ❑ 10. Domestic Fl <br /> ❑ ❑ X 11. Fannia Fl <br /> ❑ 12. Larvae <br /> ❑ Ey 11 13. Pupae <br /> El14. Adult <br /> 11 . Light Population <br /> El ❑ 1 Moderate Population <br /> ❑ 17. HeavyPopulation <br /> Structure Operation Fee 'ng/Water <br /> ❑ ❑ 18. ter Troughs <br /> 19. Cu or Bowls <br /> ❑ 20. Food tora e <br /> Stricture Operation Houses <br /> ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceih s <br /> 11 ❑ 23. Cleaning Fre uenc <br /> KENNEL <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> ❑ ❑ 2. Cross Connection <br /> Structure Operation Floors <br /> ❑ 0 3. Properly Graded to <br /> 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Covin <br /> ❑ ❑ 7. Cleaning Frequency <br /> Structure Operation Walls <br /> ❑ 11 8. Smooth/Cleanable <br /> ❑ El 9. Cleaning Frequency <br /> Structure operation Cages <br /> ❑ ❑ 10. Condition <br /> ❑ ❑ 11. Sanitation <br /> Structure Operation Food <br /> El ❑ 12. Storage <br /> ❑ El 13. Insect/Vermin <br /> Structure Operation Animal Disposal <br /> 11 ❑ 14. Removal from Premises <br /> ❑ 0 15. Other <br /> Structure Operation Sewage Disposal <br /> 11 ❑ 16. Septic System <br /> ❑ El 1 17. Sewer <br /> Structure Operation Rabies Vaccination RECEIVY INSPECTOR <br /> Li ❑ 18. Certificate on Premis <br /> EHD 40-06 6/30/2005 Page Of <br />