| 
								    		opo.ulN      					SAN JOAQUIN COUNTY
<br />      						ENVIRONMENTAL HEALTH DEPARTMENT
<br />      	a:     	•a
<br />       						1868 East Hazelton Avenue, Stockton, CA 95205
<br />       				Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sagov.org/ehd
<br />		CqC/FORa`P
<br />     					EMPLOYEE HOUSING INSPECTION NOTICE
<br />      ID #39-  			❑ Permanent Year Round(>181 days) ❑ Seasonal(5180 days) ❑Temporary    DATE:
<br />       ❑ PRE-OCCUPANCY    	❑OCCUPANCY       	❑COMPLAINT      		❑NUMBER OF OCCUPANTS:
<br />       ❑ RE-INSPECTION       	❑RE-INSPECTION    	❑POST OCCUPANCY      	❑PERMITTED OCCUPANCY:
<br />       LOCATION: 							CITY:    				CAMP TELEPHONE:
<br />       OPERATOR NAME:    											TELEPHONE:
<br />       OPERATOR ADDRESS:      					CITY:
<br />       OWNER NAME:       											TELEPHONE:
<br />       OWNER ADDRESS: 						CITY:
<br />       	CHSC.•.California Health&$afet Cade  T25-;Title 25 Callfornia.Code of„Re ulations• T24-Title 24 California Code.of.Regulations.,_
<br />	NOTICE OF VIOLATION -The items checked below are violations to be corrected:
<br />	❑  1.    Camp lacks permit to operate for current calendar year. (CHSC 17030(a))
<br />	❑  2.     Bilingual Notice not posted in conspicuous place in camp. (T25,a-624, b-625)
<br />	❑  3.     No responsible person assigned by operator to maintain the camp building and area. (CHSC 17038)
<br />	❑  4.     Name,address,and telephone number of a responsible person to maintain labor camp not posted if not residing on premises. (T25,627)
<br />	❑  5.    Application for a permit to operate not made at least 45 days prior to date of initial occupancy in current calendar year. (T25,631)
<br />	❑  6.    Camp is in violation of the permitted occupancy requirements. (T25,631)
<br />	❑  7.    Heater not installed in shower room. (T25,655)
<br />	❑  8.    Openable windows not provided with insect screening in habitable rooms. (T25,728a)
<br />	❑  9.     Solid doors or screen doors not provided with self-closing device. (T25,728b)
<br />	❑  10.   Camp area not free of depression in which water can stand. (T25,700)
<br />	❑  11.   Domestic animals and poultry running at large in camp area. (T25,702)
<br />	❑  12.   Building and grounds are not maintained in a clean and sanitary condition. (T25,a-704,b-710)
<br />	❑  13.   Building and other housing are not identified with letters or numbers at least 3"high. (T25,712)
<br />	❑  14.   Habitable rooms and sleeping areas lack sufficient window area and/or lack required openable area. (T24, 1203.4)
<br />	❑  15.   Hallways,stairways,and exit ways(except in single family dwellings)lack adequate lighting. (T24, 1001)
<br />	❑  16.   Escape or rescue windows are of insufficient size or height. (T24, 1018)
<br />	❑  17.   Rooms or areas for sleeping more than one person lack 50 square feet of floor area for each occupant. (T25,724)
<br />	❑  18.   Bed frames are rusty,deteriorated,or unsanitary. (T25,732(a))
<br />     	19.   Bedding provided by camp operator is soiled,deteriorated,or unsanitary. (T25,732(b))
<br />	❑  20.   Kitchen and/or mess hall being used for sleeping purposes. (T25,734)
<br />	❑  21.   Kitchen and mess hall not maintained in a clean and sanitary condition. (T25,a-736,b-738,c-740)
<br />	❑  22.   Inadequate storage and removal of refuse and garbage. (T25,742)
<br />	❑  23.   Lack of/inadequate approved B/C-fire extinguisher in mess hall kitchen and/or Class A(every 5000 sq.ft.)in dormitory. (T25,a-744(a),b-744(b))
<br />	❑  24.   Lack of or inadequate smoke detectors. (CH&SC 13113.7)
<br />     	25.   Articles or materials being maintained on premises creating a fire hazard. (T25,746)
<br />	❑  26    Plumbing system,fixtures,equipment,devices,and safeguards not maintained in good working order or are inadequate. (T25,a-756,b-758,
<br />    		c-760,d-762,e-764,f-766,  -768,h-788, i-790, '-792
<br />	❑  27.   Sewage disposal system failing. (T25,a-784, b-786,c-792)
<br />	❑  28.   Water supply not fit for domestic use. (T25,a-770,b-772,c-774)
<br />	❑  29.   Camp lacks adequate heating facilities. (T25,a-800, b-802)
<br /> 	❑  30.   Liquefied petroleum gas tanks inadequate(lack foundation,improperly located,lack protective barriers,lack minimum clearance,lack"No
<br />    		Smoking"sign).  T25,a-806, b-808,c-810,d-812,a-814,f-816).
<br /> 	❑  31.   Appliances lack proper vent,clearance,or shut-off valve. (T25,a-818,b-820,c-822,d-824,a-826,f-828,g-830, h-832)
<br /> 	❑  32.   Water heater lacks temperature-pressure relief valve,and/or improperly plumbed to outside of building. (T25,834)
<br /> 	❑  33.   Water heater improperly located and/or lacks adequate combustion air. (T25, a-836,b-838)
<br /> 	❑  34.   Electrical system improperly grounded,fused,or protected,or not maintained in a safe working order. (T25,a-850, b-852,c-854,d-858,a-860)
<br /> 	❑  35.   Insufficient vertical clearance for electric wires above roofs(8'),walkways,attachment point of buildings(10'),and driveways. (T25,a-862,b-864)
<br /> 	❑  36.   Lack of ground of cord-connecting equipment. (T25,a-866,b-868,c-870)
<br /> 	❑  37.   Lack of outlet in habitable room, lack of approved light fixture in bathroom and toilet room. (T25,a-872,b-874)
<br /> 	❑  387  Lack of enclosed light fixture over bathtub or in shower compartment. (T25,878)
<br /> 	❑  39.   Light/pull chain switch located in damp location/within reach of plumbing fixture,cook stove, range,furnaces. (T25,a-880,b-882,c-884)
<br /> 	❑  40.   Improper use of extension cords. (T25,a-894, b-896)
<br />      	41.   Outlet box/exposed,nonmetallic-sheeted cable not properly protected from physical or mechanical damage. (T25,a-886,b-888,c-890,d-892)
<br /> 	❑  42.   inadequate mobile home, recreational vehicle,tent. (T25,a-900, b-902,c-904,d-908,e-910)
<br /> 	COMPLIANCE DATE: ❑ Immediately ❑ Within five (5) days      		❑Within thirty (30)days
<br /> 				Any person served with a Notice of Violation may request a hearing on the matter by submitting a brief written statement
<br />      			presenting the reasons for the request to the Environmental Health Department within ten(10)days of the service of the notice.
<br />  	❑UNSAFE WATER NOTICE POSTED      ❑UNSAFE TO OCCUPY NOTICE POSTED	❑ ISSUE PERMIT TO OCCUPANCY	❑ DO NOT ISSUE PERMIT
<br />  	Received by:						Title:   				Inspection by:
<br />																	Employee Housing Inspection Notice
<br />	EHD 27-02  2/24/12
<br />
								 |