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SAN JOAQUIN COUNTY <br /> ;Z <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> I"; 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> t'= Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facilityp <br /> : �• Inspection Date: 2 <br /> � a LD <br /> Address: PE: PR#: <br /> 33 S. W1 sari 2�1 51 913,2 <br /> Owner/Operator: 9,t G +e Phone: <br /> Annual Inspection ❑Complaint Inspection [] Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: 7j #Units Inspected: 15 1 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 /> ❑ 1 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 /> 2' _ f — 6 064 nso►r� <br /> functioning sink/toilet/bath; Lack of hot water. Floors: Not clean,properly covered or in Ykk <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water I Ig— It*90 <br /> p <br /> damage, peeling or deteriorating paint;Dampness or excessive moisture in room. ^ W er�C tv,S cove. r; <br /> 9' Y+�iss�' e�rc+hc� G'00• `-' <br /> Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> F1 3' working condition; Lack of adequate heat(Standard: 70°F at 3 feet from floor). <br /> Drinking 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 /> Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> ❑ 5' foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> ❑ s Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers;Garbage receptacles unclean or in disrepair. <br /> Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other <br /> ❑ 7' 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 Ili-'B&krM Jve ,, <br /> 10. of or inadequate sn QEce detectors or fire extinguishers; Inadequate lighting; Inadequate Itg — rn(551;,S'5rvka d 441-r <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used? Yes ❑ No Company Name: Frequency: oK <br /> Hotel/Motel Business License? XYes ❑ No j 3 0 2'0 L Z' <br /> Multi-Jurisdictional Violations to be Referred to:❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: cj14 <br /> Comments: —1.,.;Le - 14 bls neA) 5*,ke- dc4r Ua;6f <br /> sE 3 &nf9i i 4alej q m "Wt 11C QrC 'r <br /> h v.,nK d o vs cr <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspectionA re-inspectionby the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialist: Phone:2� 34-5-2-- Page 1 of <br /> 2L <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />