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SAN JOAQUIN COUNTY <br /> 10 PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009, STOCKTON, CA 95202 <br /> VECTOR CONTROL INSPECTION FORM <br /> COMPUTER NO. 9Phone(209)468-3420 <br /> ��7c7s�!x�`,(f <br /> PERMIT NO. �/ o� <br /> M. OPER. DBA,,A �t Inspection Date <br /> POULTRY RANCH l"6 OL / <br /> WATER WELL Premise Address I Recheck Date <br /> 1. WELL CONSTRUCTION A= <br /> _ 2. CROSS-CONNECTION <br /> MANURE MANAGEMENT THE ITEMS BELOW REPRESENT CODE VI LATIONS AND M T BE CORRECTED: <br /> 3. SPREADING AND D19CING <br /> 4. CONCRETE TANKS <br /> 5. LAGOONING <br /> _ 6. COMPOSTING <br /> BIRO DISPOSAL <br /> _ 7. BURYING WITH 2'OF COVER <br /> _ 8. APPROVED CONCRETE TANK <br /> 9. REMOVAL FROM PREMISES <br /> VECTOR CONTROL <br /> 10. DOMESTIC FLY <br /> _ 11. FANNIA FLY <br /> 12. LARVAE <br /> 13. PUPAE tl <br /> 14. ADULT <br /> 15. LIGHT POPULATION <br /> 16. MODERATE POPULATION <br /> 17. HEAVY POPULATION <br /> FEEDING/WATER <br /> 18. WATER TROUGHS <br /> 19. CUPS OR BOWLS <br /> 20. FOOD STORAGE �' r <br /> HOUSES <br /> 21. FLOORS <br /> 22. WALLS/CEILINGS <br /> _ 23. CLEANING FREQUENCY <br /> SIR. OPER. <br /> KENNEL - <br /> WATER WELL )� <br /> 1. WELL CONSTRUCTION <br /> 2. CROSS CONNECTION l <br /> FLOORS <br /> _= 3. PROPERLY GRADED TO SEWER <br /> 4. DRAIN <br /> _ 5. SMOOTH/CLEANABLE <br /> _ 6. COVING <br /> 7. CLEANING FREQUENCY <br /> WALLS <br /> _ 8. SMOOTH/CLEANABLE D <br /> _ _ 9. CLEANING FREQUENCY <br /> CAGES <br /> _ 10. CONDITION <br /> 11. SANITATION <br /> FOOD <br /> _ 12. STORAGE <br /> 13. INSECT/VERMIN <br /> ANIMAL DISPOSAL <br /> _ 14. REMOVAL FROM PREMISES <br /> 15. OTHER <br /> SEWAGE DISPOSAL <br /> _ 16. SEPTIC SYSTEM <br /> 17. SEWER <br /> RABIES VACCINATION <br /> -- 18. CERTIFICATE ON PREMISES SA RIAN RECEIVED BY <br /> M EH 07-01(844 <br />