Laserfiche WebLink
ot`au l.y c <br /> ,:.. <..p SAN JOAQUIN COUNTY <br /> w - X 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 /> �rFOR� <br /> VECTOR CONTROL INSPECTION FORM <br /> jffMffffMffjEM DBA NSP TION <br /> Structure Operation Water Mill /0 pet <br /> ❑ ❑ 1. Well Construction, PREMISE ADDRESS RE-NSPEC ION DATE <br /> ❑ ❑ 2. Cross-Conn <br /> Structure operation Manure Manadernent 0 VOP&hATOR PHON <br /> 11 E] 3. Spreads and Disking V I �7 /00 <br /> ❑ ❑ 4. Conc a Tanks 0 CTIO TYPE PROGRAMELEMENT RECORD ID <br /> ❑ [15. Lag ning ()1%.!/ <br /> ❑ ❑ 6. Co posting The items below represent code violations and must be corrected: <br /> Structure Operation Bir Disposal <br /> ❑ ❑ 7. u 'n with 2"of Cover <br /> ❑ ❑ <br /> Approved Concrete Tank A <br /> ❑ ❑ 9. Removal from Premises i dkl� <br /> Structure operation Vector Control <br /> ❑ ❑ 1 10. Domestic FI <br /> 11 11. Fannia FlyIfc <br /> ❑ 12. Larvae : <br /> ❑ 13. Pupae <br /> ❑ El 14. Adult <br /> ❑ ❑ 15. Light Population <br /> ❑ ❑ 16. Moderate Population " doUk& r <br /> relreivW <br /> ❑ ❑ 17. Heavy Population A. <br /> , e <br /> Structure Operation Feeding/Water G <br /> ❑ ❑ 18. Water Troughs <br /> ❑ ❑ 19. Cu s or Bowls rtm D ve d vv Q.. <br /> 20. Food Storage �. <br /> Structure Operation Houses Cs aj <br /> ❑ ❑ 1 21. Floors <br /> ❑ ❑ 22. Walls/Ceilings <br /> ❑ ❑ 23. Cleanin Fre uenc f <br /> Structu Operation !Y,%Well <br /> ❑ ❑ l.'219WConstruction <br /> 2. Cross Connection <br /> Structu Operation Floors • <br /> ❑ rorlGraded to Sewer <br /> 11 ❑ 4. D in v4k Cd kPA Kd cag's/ <br /> ❑ ❑ 5. ooth/Cleanable <br /> 6. goving <br /> Cleaning Frequency <br /> Structu O oration t vrk qQpd r epcckr <br /> ❑ ❑ 8. Smo h/Cleanable <br /> ❑ ❑ --Q. ninq Frequency <br /> Structu oration 49s <br /> ❑ ❑ 10. Con itionv1qLqAim-sr <br /> station C- 4� <br /> Structu tion <br /> ❑ ❑ 12. toraUp <br /> ermin <br /> StnACtUr4t ration Ani is osal <br /> ❑ ❑ K Removal, m Premises <br /> ❑ ❑ 15. r <br /> Structu O ration a Disposal <br /> ❑ ❑ 16. SepticS tem p <br /> ❑ ❑ rWA44k <br /> �}P <br /> Structure n R Vaccination IV D By I C <br /> ❑ ca & Ce0iiicate on Premise <br /> VECTOR CONTROL INSPE FORM <br /> EHD 40-06 12/04/08 <br /> Page_/of <br />