Laserfiche WebLink
o�Qul" SAN JOAQUIN COUNTY <br /> _ y ENVIRONMENTAL HEALTH DEPARTMENT <br /> W < <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> . ����=oR���• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA INSPECTION DATE <br /> Structure Operation - 2 / <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS REIN PECTION DATE <br /> ❑ ❑ 2. Cross-Connection c!F. e t C r" Iled . f <br /> Structure Operation Manure Management OWNER/00ERATOR PHONE <br /> ❑ ❑ . Spreading and Disking Z4 0§"- S'-S'q <br /> ❑ ❑ 1 4. Concrete Tanks INSPECTION) PE PROGRAM ELEMENT RECORD ID <br /> ❑ 5. Lagooning V Ll 2 Q cr <br /> ❑ ❑ 6. composting The iteriS below represent code violations and must be corrected: <br /> Structure operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover i <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises <br /> Structurej0peration Vector Control <br /> ❑ 10. Domestic FI I .El 11. Fannia FI❑ 12. Larvae <br /> ❑ 13. Pupae <br /> ❑ ❑ 1 14. Adult <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure operation FeedingMater ( i <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 1 19. Cups or Bowls <br /> 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors 4 <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleaning Frequeng <br /> MEMEMENEW <br /> C <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> 2. Cross Connectio <br /> Struc Operation Floors <br /> ❑ N ❑ 3. Properly Grad to Sewer <br /> ❑ ❑ 4. Drain <br /> ❑ 5. Smooth/Cfeanable <br /> ❑ 6. Covin <br /> 11 7. Cleanj6g Clean' Frequency <br /> Structure Operation Walls <br /> ❑ ❑ . S ooth/Cleanable <br /> ❑ ❑ 9vleaning Frequency ,r <br /> Structure Operation 9akes <br /> ❑ ❑ 10. ndition <br /> Lj 11. Sa 'tation <br /> Structure OperatiorV Food ' <br /> ❑ ❑ 12. Stora <br /> El EY 13. Inse renin <br /> Structure o tion Animal Dis sal <br /> ❑ ❑ 14. Removal froPremises <br /> ❑ ❑ 15. Other el <br /> Stricture operation Sewage Dispo I <br /> ❑ ❑ 16. Septic Sy-Mm <br /> ❑ 17. Sewer f j <br /> S re Operation Rabies Vaccination RECEIVED BY INSPE TOR <br /> ❑ ❑ 18. Certificate on Premis <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page tof <br />