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SAN JOAQUIN COUNTY <br /> _ J ENVIRONMENTAL HEALTH DEPARTMENT <br /> -< <br /> Y. <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> Irl;0 ® p� <br /> VECTOR CONTROL FORM <br /> DBA INSPECTION DATE <br /> Structure Operation "��-� -?t <br /> ❑ ❑ 1. Well Construction PRE/MISE ADDR RE-INSPECTION DATE <br /> 116❑ 2. Cross-Connection &Y671 r <br /> Structure Operation Manure ManagerneAt OWNER/OPERATOR <br /> P ONE <br /> ❑ ❑ 3. Spreading and Di ing 47 gf _�s- <br /> ❑ ❑ 4. Concrete Tank INSP CTION TYPEPROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. Lagooning 61 Ako <br /> ❑ ❑ 6. Compostinv The items below represent code violations and must be corrected: <br /> Structure Operation Bird Dispo al <br /> ❑ ❑ 7. Buryin4ith 2"of Cover s{ <br /> ❑ ❑ 8. Apprq4ad Concrete Tank <br /> ❑ ❑ 9. Re oval from Premises moo` <br /> Structure Operation Vecj6r Control <br /> ❑ ❑ 10 Domestic FI <br /> Fannia FI <br /> ❑ ❑ 12. Larvae <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ ❑ 15. Light Population <br /> ❑ 16. Moderate Population <br /> ❑ 17. Heavy Population <br /> Structure peretion Feeding/Water <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cups or Bowls <br /> 20. Food Storage <br /> Structu Operation Houses <br /> ❑ 21. Floors <br /> ❑ 22. Walls/Ceilings J <br /> ❑ ❑ 23. Cleaning Frequency <br /> Structure Operation stet <br /> ❑ ❑ 1. Well Construction <br /> El 2. Cross Connection <br /> Structure Operation 10 <br /> Properly Graded to Sewer <br /> ❑ ❑ E4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> 1:1 El 6. Covin <✓ <br /> 7. leaning Frequency <br /> Structure Operation walls <br /> ❑ ❑ . Smooth/Cleanable <br /> ❑ ❑ . Cleaning Frequencyi <br /> Structure Operation <br /> ❑ ❑ 10. Condition <br /> El 1 nitation <br /> StructureOperatto FO <br /> ❑ ❑ M. Storage <br /> 13. Insect/Vermin <br /> Structure Oparauo Animal Disposal <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Oth <br /> Structure Operation ewage Dis <br /> ❑ ❑ e tic System <br /> ❑ ❑ 1 <br /> es VaC <br /> Structure Oper t' Rabin RECEIVED INS-P C R <br /> ❑ 18. Certificate on Premises ` <br /> VECTOR CONTROL INSPECTION FORM <br /> EHD 40-06 4/6/12 Page Of <br />