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SAN JOAQUIN COUNTY Of <br /> 2 �r� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> ... ;� • Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> VECTOR CONTROL S E TION FORM <br /> DBA INSPECTION DATE <br /> Structure Operation '� r 71/1/_3 <br /> ❑ ❑ 1. Well Construction PREMISEAID/RES RE-INSPECTION DATE <br /> ❑ El ////2. Cross-connection <br /> Structure Operation Manure Mana em t OWNER/OPERATOR 0,00s,31 <br /> PHONE <br /> El [33. Spreading and D' ing ( ,3 ^ 7,f <br /> ❑ ❑ 4. Concrete Tan INSPECTION TYPE PROGRAM ELEMENT RECORD ID <br /> E] El5. Lagooning 4";r '-y AA C P' <br /> ❑ ❑ 6. Composti The items below represent code violations and must be corrected: <br /> Structure Operation Bird DIS sal <br /> ❑ ❑ 7. Bu i with 2"of Cover <br /> ® ^.r <br /> ❑ ❑ 8. A oved Concrete Tank <br /> E] 11 9. moval from Premises <br /> Structure Operation V Otor Control <br /> ❑ ❑ A. Domestic FI <br /> El 11. Fannia Flyd <br /> El El 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ 14. Adult <br /> ❑ 111 15. Light Population <br /> ❑ ❑ 16. Moderate Population <br /> ❑ ❑ 17. Heavy Population <br /> Structure Operation Feeding/Water <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cups or Bowls <br /> 20. Food Storage <br /> St r cture Operation Houses t s e <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleaning Frequency <br /> Structure Operation Ater W <br /> ❑ ❑ ell Construction <br /> 2. Cross Connection <br /> Structure Operation 6brS 16ce <br /> Properly Graded to Sewer �-*. <br /> ❑ ❑ 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> 11 El 6. Covin <br /> El 7. Cleaning Frequencypp <br /> Structure Operation a s <br /> ❑ ❑ 8. Smooth/Cleanable <br /> ❑ ❑ 1 9. Cleaning Frequency <br /> Structure Operation e Ca <br /> ❑ ❑ 10. Condition <br /> 11. Sanitation <br /> Structure Operation <br /> ❑ ❑ 12. Storage <br /> 13. ct/Vermin <br /> Structure Operation Animal Dis os I <br /> ❑ ❑ 1 14. Removal from Premises <br /> ❑ ❑ 15. O <br /> Structure operation ewage Disposal-- <br /> ❑ ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer <br /> Structure Operatio les vaccination E D IN P CTOR <br /> ❑ ❑ 8. Certificate on Premises <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 4/6/12 Ito <br /> Page_of <br />