Laserfiche WebLink
¢a`'•" SAN JOAQUIN COUNTY 10 <br />to..y2< ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />VECTOR CONTROL INSPECTION FORM <br />VECTOR CONTROL INSPECTION FORM <br />EHD 40-06 12/04/08 <br />Page of <br />Emmmomm <br />DBA <br />`� <br />INSPECTIO D/lyTE <br />Structure <br />Operation <br />t7 <br />❑ <br />❑ <br />1. Well Construction <br />PREMISE D <br />RE -Ills CTION ATE <br />11 <br />2. Cross -Connection <br />Structure <br />Operation <br />Manure Management <br />NNE.PHONE <br />OPERA R <br />1:1 <br />E]3. <br />Spreading and Disking <br />V Z r <br />❑ <br />❑ <br />4. Concrete Tanks <br />SP CTION TYPE <br />PROGRAM ELEMEW <br />RECORDID <br />❑ <br />5. Lagooning <br />dLD <br />❑ <br />❑ <br />6. Composting <br />The items below represent code violations a d must be corrected: <br />Structure <br />Operation <br />Bird Disposal <br />❑ <br />❑ <br />7. Bu in with 2" of Cover <br />e.. <br />>&t' <br />dm <br />❑ <br />❑ <br />8. Approved Concrete Tank <br />❑ <br />❑ <br />9. Removal from Premises <br />d1i <br />Structure <br />Operation <br />Vector Control <br />❑ <br />❑ <br />10. Domestic FI <br />11. Fannia FI <br />❑ <br />❑ <br />12. Larvae <br />❑ <br />❑ <br />13. Pupae <br />❑ <br />❑ <br />14. Adult <br />❑ <br />❑ <br />15. Light Population <br />❑ <br />❑ <br />16. Moderate Population <br />S <br />❑ <br />❑ <br />17. Heavy Population <br />Stricture <br />Operation <br />FeedingMlater <br />❑ <br />❑ <br />18. Water Troughs <br />❑ <br />❑ <br />19. cups or Bowls <br />tAo <br />ctc a oturr <br />20. Food Stora <br />Structure <br />Operation <br />Houses <br />❑ <br />❑ <br />21. Floors <br />❑ <br />❑ <br />22. Walls/Ceilings <br />❑ <br />❑ <br />23. Cleanin Fr uenc <br />Structure <br />Operation <br />Water Well <br />❑ <br />❑ <br />1. Well Construction <br />� <br />2. Cross Conn ion <br />Structure <br />Operation <br />Floors <br />t <br />13 <br />3. Properly G ed to Sewer <br />❑ <br />❑ <br />4. Drain <br />❑ <br />5. Smoo Cleanable <br />CR <br />6. Covi <br />7. C190ninq Fre uenc <br />Structure <br />Operatlo <br />Wa s <br />❑ <br />❑ <br />8 Smooth/Cleanable <br />❑ <br />❑ <br />V. Cleaning Frequency <br />Structure <br />Operation <br />ages <br />❑ <br />❑ <br />10. Condition <br />11. Vanitation <br />Structure <br />operati n <br />FOO <br />❑ <br />12. St e <br />13. Inseblivermin <br />Structure <br />Op tion <br />Animal 0iiii6sat <br />❑ <br />14. Remova m Premises <br />❑ <br />❑ <br />15. Other <br />Structure <br />jbperation <br />Sewage Disposal <br />❑ <br />❑ <br />16. Septic System <br />❑ <br />❑ <br />17. Sewer <br />Structure <br />Operation <br />Rabies Vaccination <br />RECEIV BY <br />INS T <br />11❑ <br />18. Certificate on Premises <br />VECTOR CONTROL INSPECTION FORM <br />EHD 40-06 12/04/08 <br />Page of <br />