Laserfiche WebLink
,oag, �. o SAN .10AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.s'gov.org/ehd <br /> `'FOR`'�p HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: '16 0Y f7Inspection Date: Otl Z Z <br /> Address: 'ISI_ V'o yc�' PE: Z+��� PR#:Q2 Ov CSO <br /> Owner/Operator: 7)� T &A'1' -�-C / Phone: c� <br /> nnual Inspection ❑ Complafnt Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: #Units Inspected: Reinspection On or About: <br /> The items checked below are violations to be corrected. <br /> See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): <br /> Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> ❑ garbage,combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br /> F-1 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean,properly covered or in <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> ❑ 3 Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). <br /> Drinkinq Utensils&Ice Buckets: Not protected from contamination; Lack of or improper <br /> ❑ 4. washing&sanitizing after each use(multi-use); Lack of or improper protective bagging <br /> (multi-use)or individual protective wrapping (single-use). <br /> ❑ 5 Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ 7 Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways,exits,or other <br /> publicly shared spaces. <br /> ❑ 8. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack uji-f2 C ed as l j a— <br /> PK 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate k� <br /> protection from weather; Inadequate sewage or water facilities. `\t f(,A&Ox V L7vtt,ec� <br /> Pest control Used? es ❑ No Company Name: 0�' Frequency: <br /> Hotel/Motel Business License? [ Yes ❑ No 'Z Z <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: <br /> Comments: % Kv , he uit ,3K ( <br /> tL v cxt i(�a rl <br /> rl 2 :'('r st <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environme/Inn ea t Specia ist: Phone:22 �YCC M� 7 q S J 9w/ Page 1 of <br /> EHD 2 0 -30-12 ( J HOTEUMOTEL OR <br />