Laserfiche WebLink
o SAN .TOA IN COUNTY (41 <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> Telephone.(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> VECTOR CONTROL INSPECTION FORM <br /> POULTRY RANCH DBA /j INSP CTIION DATE <br /> Structure Operation Water Well ®ice .F ( 14 <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS RE NSPE ION DATE <br /> ❑ ❑ 2. Cross-Connection r1 <br /> Structure Operation Manure Management OWNER/OPERATOR PHONE <br /> ❑ ❑ 3. Spreading and Disking <br /> ❑ ❑ 4. Concret Tanks INSP CTION TYPg PROGRAM ELEMENT RECORD ID <br /> ❑ ❑ 5. L.agoo mg °e) 1 <br /> ❑ t3 6. Co posting The items below represent code violations and must be corrected: <br /> Structure Ope tion BirSPfDisposal <br /> ❑ a 7/Burying with 2"of Cover <br /> ❑ ❑ 4A2proved Concrete Tank <br /> t <br /> ❑ ❑ 9. Removal from Premises <br /> Structure OperatioA Vector Control <br /> ❑ EV 10. Domestic FI <br /> ❑ 1 1. Fannia Fl <br /> ❑ ❑ Larvae //l ti I <br /> ❑ ❑ I Pupae <br /> ❑ ❑ 14. dult <br /> ❑ ❑ 15. ht Population <br /> E316. eratePopulation k hqi <br /> E317. Hea Population <br /> S ucture Operation Feeding/ ater <br /> ❑ ❑ 18. Water rou hs <br /> ❑ ❑ 19. Cups or owls <br /> ❑ ❑ 20. Food Sto e <br /> t <br /> Structure Operation Houses <br /> ❑ ❑ 21. Floors <br /> ❑ ❑ 22. Walls/Ceilin <br /> ❑ El 3. Cleaning Frequent <br /> KENNEL <br /> Structure Operation Water Well <br /> ❑ 13 1. Well Construction <br /> ❑ 11 2. Cross Connection <br /> Structure Operation Floors <br /> ❑ ❑ 3. Properly Graded to <br /> ❑ 13 4. Drain <br /> ❑ ❑ 5. Smooth/Cleanable <br /> ❑ ❑ 6. Covin <br /> ❑ ❑ 7. CleaningFre uenc <br /> Structure Operation Walls <br /> ❑ ❑ 8. Smooth/Cleanable <br /> El 11 9. Cleaning Frequency <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> ❑ ❑ 11. Sanitation <br /> Structure Operation Food <br /> ❑ 12. Storage <br /> ❑ ❑ 13. Insect/Vermin <br /> Structure Operation Animal Disposal <br /> 11 ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other <br /> Structure Operation Sewage Disposal <br /> ❑ 0 16. Septic S stem <br /> ❑ ❑ 17. Sewer <br /> Structure Operation Rabies Vaccination RECEIVED BY INSPECT <br /> 13 1:1 r <br /> 18. Certificate on Premises 1 0� <br /> EHD 40-06 6/30/2005 Page of <br />