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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION P.O. BOX 2009, STOCKTON, CA 95202 VECTOR CONTROL INSPECTION FORM COMUTER NO. Phone(209)468-3420 P� IT NO. 5000 ft- STR. OPER. DBA InspectionI Date POULTRY RANCH Ins RO r I'l `? l 7 WATER WELL Premise Address f Recheck Date -- 1. WELL CONSTRUCTION ,-1 1t hale t t o RA, -- 2. CROSS-CONNECTION THE ITEMS BELOW REPRESENT CODE VIOLATIONS AND MUST BE CORRECTED: MANURE MANAGEMENT -- 3. SPREADING AND D19CING _- 4. CONCRETE TANKS l -- 5. LAGOONING C-OMa'� � 66:13 n - �) IES � at-1 O I 6. COMPOSTING BIRD DISPOSAL -- 7. BURYING WITH 2'OF COVER APPROVED CONCRETE TANK A' _ REMOVAL FROM PREMISES or VECTOR CONTROL - - 10. DOMESTIC FLY - - 11. FANNIA FLY - - 12. LARVAE ` ,� Le2t.. d, YIA+ V(k' Pe CJS IQI✓l�_A 10e 13. PUPAE ef ` � 14. ADULT c�t- , -Y 15. LIGHT POPULATION 16. MODERATE POPULATION -- 17. HEAVY POPULATION FEEDING/WATER �I - - 18. WATER TROUGHS �3� h e- _ - 19. CUPS OR BOWLS 20. FOOD STORAGE /� HOUSES r /�6GC Veap 11AS ot,>�1r Lroc S 21. FLOORS 22. WALLS/CEILINGS _ %./23. CLEANING FREQUENCY 1 ` 2- ile'ftl 194 IlArAA LA CC STR. OPER. �G )� KENNEL _ WATER WELL l -- 1. WELL CONSTRUCTION - - 2. CROSS CONNECTION FLOORS -- 3. PROPERLY GRADED TO SEWER 4. DRAIN 5. SMOOTH/CLEANABLE -- 6. COVING -- 7. CLEANING FREQUENCY WALLS 8. SMOOTH/CLEANABLE �y p�� L�Q S / - _ 9. CLEANING FREQUENCY CAGES - _ 10. CONDITION -- 11. SANITATION FOOD 12. STORAGE -- 13. INSECT/VERMIN ANIMAL DISPOSAL -- 14. REMOVAL FROM PREMISES - - 15. OTHER SEWAGE DISPOSAL 16.,SEPTIC SYSTEM _ 17. SEWER c RABIES VACCINATION ^ -- 18. CERTIFICATE ON PREMISES SANITAFTIAN RECEIVED BY 0 EH 07-01(690)