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SAN JOAQUIN COUNTY <br /> 'x ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.orQ/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: S z Inspection Date: <br /> Address: rA s �� PE �aBr PR#:OZu d8� <br /> Owner/Operator n�K Phone: <br /> j$Annual Inspection ❑ Complaint In pection ❑Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: 3U2 #Urtits Inspected: 119 1 Reinspection On or About: . <br /> The items checked below are violations to be corrected. <br /> See Reverse Side of this Form for Detailed Surnmwy 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- pjoVr�v� R rv% <br /> Z' JA <br /> functioning sinkltoilet/bath;Lack of hot water.Floors:Not clean,property covered or in � <br /> good repair.Wails&Ceilings:Walls/ceilings in need of cleaning or repair. Holes,water Ct,W y3�—SCA �t� <br /> damage,peeling or deteriorating paint;Dampness or excessive moisture in room. + kAr <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:70OF 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(muftkuse);Lack of or improper protective bagging <br /> (mufti-use)or individual protective wrapping(single-use). <br /> ❑ 5. Bedding:Mattress/linens infested with Tice,bedbugs,or other insects,Not free from filth or <br /> foul matter;Unsafe;Linens not changed weekly or before new guest. <br /> 13 adwe Receotacles: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 /> publicly shared spaces. <br /> [3 a. 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 jZ"-z_ 0 '^7-3 <br /> 1- <br /> 71 10. of or inadequate smoke detectors or fire extinguishers;Inadequate lighting;Inadequate <br /> protection from wea r, n equate sewage or water facilities. <br /> Pest control Used? [W Yes ❑No Company Name: P, &-v%444 Frequency: NJ <br /> Hotel/Motel Business License? ❑Yes ❑No <br /> Multi-Jurisdictional Violations to be Referred to:E]City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: Z F4 p 5� <br /> Comments: c,f,.c • <br /> v <br /> All violations In rooms not Inspected must also be corrected. <br /> All re-ins ctions a nv non e e -altnecurrent hourly rate. <br /> Received By: Title: <br /> Environmental Health Speciali : Phone: a 3 - paw t of <br /> L <br /> EHD 24-01 4-34-12 E-MAI MIOTEL OIR <br />