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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. Phone(209)468-3420 <br /> PERMIT NO. <br /> STR. OPER. DBA Inspection Date <br /> POULTRY RANCH C /2 C 6 y <br /> WATER WELL Premise Address Recheck Date <br /> 1. WELL CONSTRUCTION a <br /> 2. CROSS-CONNECTION 3(1634 <br /> THE ITEMS BELOW REPRESENT CODE VIOLATIONS NO MUST BE CORRECTED: <br /> MANURE MANAGEMENT / <br /> 3. SPREADING AND DI9CING ©Q �� <br /> iJ <br /> _ 4. CONCRETE TANKS /' s <br /> 5. LAGOONING r SIC -7r <br /> 6. COMPOSTING . 01 <br /> BIRD DISPOSAL <br /> _ 7. BURYING WITH 2'OF COVER <br /> s <br /> 8. APPROVED CONCRETE TANK <br /> 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> 10. DOMESTIC FLY <br /> _ 11. FANNIA FLY / <br /> _ 12. LARVAE <br /> 13. PUPAE / Q <br /> _ 4. ADULT f� OLL fCs <br /> 15. LIGHT POPULATION <br /> 16. MODERATE POPULATION <br /> 17. HEAVUPO LA ON <br /> FEEDING/WATER " Sir 3/) _ <br /> 18. WATER TROUGHS m9 :c <br /> 19. CUPS OR BOWLS <br /> 20. FOOD STORAGE <br /> HOUSES <br /> Eb� <br /> g22. <br /> 1. FLOORS <br /> WALLS/CEILINGS ` o <br /> 3. CLEANING FREQUENCY <br /> t7 <br /> STR. OPER. r hl-elr � r":::z <br /> KENNEL -- <br /> WATER WELL /4 /y 6 iZ lj <br /> L WELL CONSTRUCTION <br /> 2. CROSS CONNECTION <br /> FLOORS � r <br /> 3. PROPERLY GRADED TO SEWER f'�/ v01 <br /> 4. DRAIN <br /> 5. SMOOTH/CLEANABLE <br /> _ 6. COVING <br /> 7. CLEANING FREQUENCY A r <br /> WALLS <br /> 8. SMOOTH/CLEANABLE <br /> _ 9. CLEANING FREQUENCY <br /> CAGES <br /> 10. CONDITION <br /> 11. SANITATION C O <br /> FOOD <br /> _ 12. STORAGE <br /> 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL D / <br /> 14. REMOVAL FROM PREMISES <br /> 15. OTHER <br /> SEWAGE DISPOSAL <br /> _ 16. SEPTIC SYSTEM <br /> _ 17. SEWER C <br /> RABIES VACCINATM <br /> 18. CERTIFICATE ON PREMISES SANI-TAFIIAN RECEIVEb BY <br /> 0 EH 07-01(8-90) <br />