Laserfiche WebLink
�I <br /> SAN JOAQUIN COUNTY <br /> _ y 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 /> DB INyg <br /> AT <br /> Structure Operation <br /> ❑ ❑ luf <br /> 1. Well Construction PREMISE ADORE r REANSPECnbN DATE <br /> ❑ ❑ 2. Cross-Connection r <br /> LO <br /> Structure Operation Manure Management O ER/OPERATOR ® PH <br /> 3. <br /> ❑ ❑ 3. Spreading and Disking t <br /> El Fl4. Concrete Tanks IN ON E t PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal Nlatt <br /> r a <br /> 11 El 7. Bu in with 2"of Cover <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises ` L <br /> Structure Operation Vector Control <br /> ❑ ❑ 10. Domestic FI <br /> 11. Fannia FI <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> El 0E] 14. Adult 1OAS <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population AA (-AkAlll <br /> ❑ ❑ 17. Heavy Population l <br /> Structure Operation Feeding/Water <br /> ❑ ❑ 18. Water Troughs 1 <br /> ❑ ❑ 19. Cups or Bowls IA-aVT- LA.>� <br /> 11 0 20. Food Storage <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleanina Fr uenc <br /> r <br /> MENEEMEMEM 7) 6dt Gz�� 6(� 11-6 <br /> Structure Operation Water Well , <br /> El ❑ 1. Well Construction <br /> 2. Cross Connection <br /> Structure Operation Floors <br /> 3. Property Graded to Sewer <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable FN <br /> 6. Covin <br /> 7. Cleaning Frequencyr <br /> Structure Operation Walls Auk <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 9. Cleaning Frequency <br /> structure operation Cages <br /> ❑ ❑ 10. Condition <br /> 11. Sanitation <br /> Structure Operation Food <br /> ❑ 1 ❑ 12. Storage <br /> 13. Insect/Vermin <br /> Structure Operation Animal Dis anal <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ I ❑ 1 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies VaccinationREC Y A INS OR <br /> 11 1118. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page of <br />