Laserfiche WebLink
SAN JOA COUNTY <br />o c <br />VIRONMENTAL HEALTH DEPART NT <br />304 East Weber Avenue, 3`d 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 �OMCAC�MINSPECTI N D E <br />Structure Operation Water Well LM <br />❑ ❑ 1. Well Construction PREMISE ADDRESS ® REINS CTI DATE <br />t <br />❑ ❑ 2. Cross-Connection i <br />Structure Operation Manure Management OWNS OPERA OR PHONE <br />❑ ❑ 3. Spreading and Disking <br />❑ ❑ 4. Concrete Tanks INS ECTI TYPE PROGRAM ELEMENT RECORD ID <br />❑ ❑ 5. Lagooning t <br />❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br />Structure Operation Bird Disposal <br />c <br />❑ ❑ 7. Burying with 2" of Cover <br />❑ ❑ 8. ApEroved Concrete Tank <br />• <br />❑ ❑ 9. Removal from Premises <br />46 <br />Structure Operation Vector Control <br />❑ ❑ 10. Domestic Fl <br />❑ ❑ <br />11. Fannia Fl <br />❑ ❑ 12. Larvae <br />❑ ❑ 13. Pupae <br />❑ ❑ 14. Adult 02_1� Cob <br />❑ ❑ 15. Light Population <br />❑ ❑ 16. Moderate Population <br />❑ ❑ IT Heavy Population <br />Structure Operation Feeding/Water <br />❑ ❑ 18. Water Troughs <br />❑ ❑ 19. Cups or Bowls <br />❑ ❑ 20. Food Storage <br />Structure Operation Houses <br />❑ ❑ 21. Floors <br />❑ ❑ 22. Walls/Ceilings <br />❑ ❑ 23. Cleanin Fre uenc <br />KENNEL <br />StructureOperation Water Well T <br />❑ ❑ 1. Well Construction j <br />❑ ❑ 2. Cross Connection , <br />Structure Operation Floors <br />❑ ❑ 3. Properly Graded to <br />❑ El 4. Drain <br />❑ ❑ 5. Smooth/Cleanable <br />❑ ❑ 6. Covin <br />❑ ❑ 7. Cleaning Frequency <br />Gil akA <br />Structure Operation Walls % C <br />11❑ 8. Smooth/Cleanable <br />❑ 0 9. Cleaning Frequency <br />Structure Operation I Cages <br />11 ❑ 10. Condition <br />❑ ❑ 11. Sanitation <br />Structure Operation Food <br />❑ 12. Storage <br />❑0 13. Insect/Vermin <br />Structure Operation Animal Disposal ' t <br />❑ ❑ 14. Removal from Premises I U C, f <br />❑ ❑ 15. Other _ c <br />cwaad 'Z_ <br />Structure Operation Sewage Disposal <br />❑ ❑ 16. Septic System <br />❑ ❑ 17. Sewer <br />DP 40 '6 Wma- <br />Structure Operation Rabies Vaccination RECEIVED BY I IINSPE OR <br />❑ ❑ 18. Certificate on Premises <br />EHD 40-06 6/30/2005 Page - of <br />