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PQU1� SAN JOAQUIN COUNTY ENVkONMENTAL HEALTH DEPARTML�T 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: L 0A40S ItOML Inspection Date: Address: 34.3 1, <. /N J006.'[WtN Jr J'tOGKPQ/J PE: 2y/? PR#0'2yoDSB Owner/Operator: VIV16 d /<. Pry Phone: 'Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: 2---� ; #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): E Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, garbage,combustible items or similar materials. Room Maintenance; General lack of repair or improper maintenance; Broken or non- F-1 2' functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in good repair. Walls&Ceilings:Walls/ceilings in need of cleaning 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). ❑ 5. Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ s. 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. ❑ 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:0o9j7LC Mj-7- all ,Aoe fHC,[/Frequency: I x 9 riuN1H 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: /06 X94 /10 1/Og 21-3-i 7_12- Comments: 1ZComments: c CY1NvAI M Kf tz?tN_ �fAvtYL CH -;Lirr Pin �- hYwwoff IUlo 6E �Lo✓�ppt7 m p(i://Y�1UT1' fjr ^/ (001 OL IV AAlf VrtPayL- fivffill oG . pi thT�k /laow. 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 Title: Environmental Health Specialist: Phone: Page 1 of / EHD 24-01 4-30-12 HOTEUMOTEL OR