Laserfiche WebLink
n.. <br /> SAN JOA IN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> to <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 /> , <br /> Structure Operation Water Well V, S� <br /> ❑ ❑ 1. Well Construction PREMiseADDVSS (tel t REIAd0EcfIcW DATE <br /> El 2. Cross-Connection <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking IrOL, A jLA " S38-XILA❑ 4. Concrete Tanks INSPECTION TYPE 1 PR;RAm ELe ENT RECORD ID <br /> ❑ ❑ 5. Lagooning W <br /> ❑ ❑ 6. Composting The items below represent code violations and must be correct d: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover d e <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ 11 9. Removal from Premises 1> A- <br /> Structure Operation Vector Control <br /> El ❑ 10. Domestic FI <br /> 11 ❑ 11. Fannia Fl <br /> 9 <br /> ❑ ❑ 12. Larvae Lti <br /> ❑ ❑ 13. Pupae <br /> El ❑ 14. Adult <br /> ❑ 15. Light Po ulation <br /> El ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑ ❑ 18. Water Troughs <br /> ❑ 19. Cups or Bowls t'L <br /> ❑ ❑ 20. Food Stora e <br /> Structure Operation Houses <br /> ❑ 0 21. Floors <br /> El El22. Walls/Ceilin s <br /> ❑ ❑ 23. Cleaning Fre uenc <br /> KENNEL <br /> Structure Operation I Water Well <br /> ❑ 1. Well Construction 4 <br /> El ❑ 2. Cross Connection <br /> Structure Operation Floors 0dr F L <br /> El ❑ 3. Properly Graded to <br /> ❑ ❑ 4. Drain ® 0 <br /> ❑ ❑ 5. Smooth/Cleanable ' ® 5 �- <br /> El 136. Covin ' l <br /> ❑ ❑ 7. Cleaning Frequency <br /> Structure Operation Walls <br /> ❑ 8. Smooth/Cleanable <br /> ❑ 11 t> I <br /> Structure Operation I Cages <br /> ❑ ❑ 10. Condition <br /> ❑ ❑ 11. Sanitation <br /> Structure Operation Food <br /> ❑ ❑ 12. Storage <br /> El ❑ 13. Insect/Vermin <br /> Structure Operation Animal Disposal <br /> ❑ 14. Removal from Premises <br /> ❑ 15. Other <br /> Structure operation Sewage Disposal 0 <br /> ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure operation Rabies VaccinationEC V B I ECTOR <br /> v <br /> 11 El18. Certificate on Premises <br /> EHD 40-06 6/30/2005 J, Page_of_ <br />