Laserfiche WebLink
403AN JOAQUIN COUNTY <br /> `s ENVIRONMENTAL HEALTH DEPARTMENT <br /> :. '. 600 East Main Street Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> �/FOR <br /> VECTOR CONTROL INSPECTION FORM <br /> DBA IN�P3TI N DATE o <br /> Structure Operation Water Well I vio <br /> ❑ ❑ 1. Well Construction PREMISE ADDRESS �f ,,A �� RE-INSPECTION DATE <br /> ❑ ❑ 2. Cross-Connection . (.DPW l <br /> Structure Operation Manure Management/ OWNS O RAT,OR PHONE <br /> ❑ ❑ 3. Spreading and Disk' g �A V Q.✓b ne- q/v --2-v U c <br /> ❑ ❑ 4. Concrete Tanks INSPECTION TYPEPROGRAM ELEMENT R ORD ID ( , <br /> ❑ ❑ 5. Lagooning n N 5 L) <br /> ❑ ❑ 6. Composting The items below represent code violations and must be corrected: <br /> Structure Operation Bird Dispo I <br /> ❑ ❑ 1 7. Burvindith 2"of Cover <br /> ❑ ❑ 8. A r ed Concrete Tank ( d� <br /> E] El 9. Re oval from Premises S �i�&0, <br /> Structure Operation Vec r Control <br /> ❑ ❑ 1 Domestic FI <br /> Fannia FI /) f 1 C D <br /> El El00 12. Larvae (� S v41`.yA <br /> ❑ ❑ 13. Pupae <br /> ❑ ❑ 14. Adult <br /> ❑ 15. Light Population `���(,� p� /�� <br /> ❑ 16. Moderate Po ulation V �C Q� �l a S <br /> ❑ 17. Heavy Population � Ott <br /> ,v�`tr/2v`Ie e K0,1V1 0 V 7 ,^► <br /> Structure Aeration Feeding/Water T ` Lr"�fC/ <br /> ❑ ❑ 18. Water Troughs c e ,M <br /> E] 1119. Cu s or Bowls D't �X C r-t yK'-/ ' 'h-o m kt r1.1vj S <br /> ❑ ❑ 20. Food Storage <br /> Struct Operation Houses <br /> ❑ 21. Floors ���� ca� a ot� j� i <br /> ❑ 22. Walls/Ceilings (r.�+�l 'lM4 b <br /> ❑ ❑ 23. Cleanin Fre uenc i G(Ak�vi r j <br /> Structure operation Water Well / }},, p <br /> ❑ ❑ 1. t?Jl nstruction �� �/ 1 V/�(Qs v', <br /> ❑ ❑ 2. Cross Connection <br /> Structure peration Floors <br /> ❑ 3. Properly Graded to Sewer 'F c� ftd i T\ 0 is �..iy, <br /> ❑ 4. Drain 11� 1�J1.. <br /> ❑ ❑ 5. Smooth/Cieanabie 1 ,� <br /> ❑ ❑ 6. Covin 1f1. <br /> ❑ ❑ 7. CleaningFrequency <br /> Structure Operation Walls <br /> El 8. Smooth/Cleanable <br /> ❑ Ar ❑ 9. Cleaning Frequency Ij,K� Va cc�'l <br /> Structure Operation Cages <br /> ❑ ❑ 10. Condition <br /> ❑ 11. Sanitation _)_,, ' +1 ` <br /> Structure Operation Food ��1 `�1�1 l��c�, I h l �✓V '"�r <br /> ❑ � 12. Storage 4i � local i ®��l CG <br /> 13. InsectNermin t�rl. <br /> Structure Operation Animal Disposal <br /> ❑ ❑ 14. Removal from Premises <br /> ❑ ❑ 15. Other PJ �/a , /+o1� N !S 11 n <br /> structure Operation Sewage Disposal 1 li <br /> ❑ 16. Septic System <br /> ❑ ❑ 17. Sewer �� <br /> Structure Operation Rabies Vaccination VED S''Y INSPECTO <br /> ❑ 18. Certificate on Premise <br /> VECTOR CO TROL INSPECTION FORM <br /> EHD 40-06 12/04/08 <br /> Page-of <br />