Laserfiche WebLink
r <br /> SSAN JOAQUIN COUNTY <br /> r 'y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street Stockton, CA 95202-3029 <br /> . c��:, _ ;�• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �IFOR <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA INSPEC ION ,DATE <br /> Structure Operation i- "d44 f < <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE-I SPECTION DATE <br /> ❑ ❑ 2. Cross-Connection 2179 <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking f-) <br /> ❑ ❑ 4. Concrete Tanks INSPECTION TYPE PROGRAM ELEMENT RECORD ID <br /> ❑ 5. Lagooning ys- <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Disposal <br /> ❑ ❑ 7. Burying with 2"of Cover t if <br /> ❑ ❑ 8. Approved Concrete Tank <br /> ❑ ❑ 9. Removal from Premises <br /> Structure Operation Vector Control <br /> ❑ ❑ 10. Domestic FI <br /> 11 11. Fannia FI <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ ❑ 15. Light Population 1 <br /> ❑ ❑ 16. Moderate Population ! A r a <br /> ❑ ❑ 17. 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. Cleaning Frequency <br /> MESSEEMEM <br /> Structure Operation Water Well <br /> ❑ ❑ 1. Well Construction <br /> 2. Cross Connection <br /> Structure Operation Floors <br /> ❑ ❑ 3. Proed Graded to Sewer <br /> ❑ ' ❑ 4. Drain <br /> *11 El5. Smooth/Cleanable6. Covin7. Cleanin Frequency <br /> Operation Walls <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 1 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> 11. Sanitation , <br /> Structure Operation Food <br /> ❑ ❑ 12. Storage <br /> 11 11 13. Insect/Vermin r' <br /> Structure Operation Animal Disposal <br /> ❑ 01C ❑ 14. Removal from Premises <br /> ❑ 1❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operhtion Rabies Vaccination VED Y INSPECT R <br /> ❑ OZ ❑ 18. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page of <br />