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SAN JOAQUIN COUNTY <br /> �z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �IFOR�`4 HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Am Par Z Inspection Date: <br /> Address: ssb rt-ey A' aCn PE:2 o PR#:OZ 60-941 <br /> Owner/Operator: tkA 6GV Y Phone:/to Y dp_ 032 ' <br /> Annual Inspectio6 ElComplaint Inspection ElConsultation Inspection ElRe-inspection <br /> #Units in Facility: 7 U #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 /> 1' garbage,combustible items or similar materials. 3 3 no[ (^Ir CKZS <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or kn- Z �Q <br /> 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in f d��G of <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water �9 <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. r <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 /> 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 /> ❑ Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> 6' 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. 2w4( Floor 4,17- <br /> Other <br /> ,1yOther Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards; Lack" tsI, Lrc / j U )Z7'_' tf <br /> 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate j 1 V,61 O Cj <br /> protection from weather; Inadequate sewage or water facilities. �a r� ' Zf al, <br /> Pest control Used?Kyes ❑ No Company Name: -C U CZ Frequency: 7V p <br /> Hotel/Motel Business License? Xf Yes ❑No /4 ZZ <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: S ? j :' `j` y L[(J <br /> Comments: <br /> e e );j, cUnn'�_2v-(--.3 <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections by the Environmental Health Department will 130,Chilled at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialist:. �l�S C [� Phone: — C1 Page 1 of <br /> EHD 24-01 4-30-12 /� HOTEUMOTEL OIR <br />