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R4�f6SAN .1OAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ` 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.slgov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: 9E,_.r,3 f�iDT�L Inspection Date: fJl d s his Address: PE: 241 )-JC474JOF}Qf.)0J J"'T(LC-ET t"'06K7c�.) Owner/Operator: t7(LVINb f'RTE!_ I Phone: ❑Annual Inspection Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection # Units in Facility: #Units Inspected: Reinspection On or About: The items checked below are violations to be corrected. See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, garbage,combustible items or similar materials. Room Maintenance: General lack of repair or impro ance; Broken or non- 2 functioning sink/toilet/bath, Lack of hot water. FI rs: Not clean, operly covered or in good repair. Walls& Ceilings: Walls/ceilings inn Hing or repair: Holes,water damage, peeling or deteriorating paint; Dampness or excessive moisture in room. ❑ 3. Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, working condition; Lack of adequate heat(Standard: 70°F at 3 feet from floor). Drinking Utensils& Ice Buckets: Not protected from contamination; Lack of or improper ❑ 4. washing &sanitizing after each use(multi-use); Lack of or improper protective bagging (multi-use)or individual protective wrapping(single-use). Bedding: Mattress/linens infested with lice edbu _ r other insects; Not free from filth or (� 5' foul matter; Unsafe; Linens not changed week y or before new guest. ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate close fitting covers; Garbage receptacles unclean or in disrepair. ❑ 7. Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways, exits, or other publicly shared spaces. 8. Pest Control: Infestation of insects, vermin or rodents. C�IGK 2r/ftC�t1 �O ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Electrical, structural, or plumbing hazards; Lack ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? Yes ❑ No Company Name: ONT PST Frequency: Km 7711, Hotel/Motel Business License? ❑ Yes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other Rooms inspected: (� Comments: 001P1,f 7MT 94Gel vCO 6 mF C JI r /tv04 wpm 6&79 X VA r 11>40 cocKof-4164' OC6u r 0►U97nD Rftn tic mv 0 C--64 CIL/ajew ^InJ Wd e-j- 4s l rmi enr wr,,"r.E irCE wvi o if-i -N rnf lZoc". All violations in rooms not inspected must also be corrected. All re-inspections by the Environmental Health Department will be billed at the current hourly rate. Received By: X r—�, pl." () / �� Title: Environmental Health Specialist: C nt Phone: _y�fi Page 1 of /L EHD 24-01 4-30-12 /�'�' HOTEL/MOTEL OIR