Laserfiche WebLink
A4 y SAN JOAQUIN COUNTY <br /> olwlphloer <br /> 'pc°4 ENVIRONMENTAL HEALTH DEPARTMENT <br /> w -c� ' Z{ <br /> 1868 East Hazelton Avenue , Stockton , CA 95202-6232 <br /> � • do <br /> Telephone: (209 ) 468 . 3420 Fax: (209 ) 464 -0138 Web: www . sigov . org /ehd <br /> t� Fb % <br /> HOTEL/ MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility : n G Inspection Date : � Z ZC�y C> <br /> A Quin 04 <br /> Address : 1 � U1/1 VVt ' �"I � 1f I P V 1 P `To , <br /> Owner/Operator. ; / (� P ' 0 q 5 'Z — - OQ <br /> `� Annua Inspection ❑ Complaint 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 /> Awl I, <br /> Room Cleanliness : Lack of cleanliness & sanitation ; Accumulation of debris , trash , <br /> 1 <br /> garbage , combustible items or similar materials . 1r'W <br /> Room Maintenance : General lack of repair or improper maintenance ; Broken or none �� <br /> 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 /> r : <br /> damage , peeling or deteriorating paint; Dampness or excessive moisture in room . <br /> ❑ <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 /> ❑ <br /> r 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 /> ❑ 6 . 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 U Conditions : Electrical , structural , or plumbing hazards ; Lack <br /> 10 . of or inadequamte4qaLdetect or fire extinguishers ; Inadequate lighting ; Inadequate 0 <br /> protection from weather' equate sewage or water facilities . FU (k <br /> Pest <br /> Pest control Used ? IRYes ❑ No Company Name : EtYI I AN Frequency: <br /> Hotel/Motel Business License? [ Yes El No !, ( . <br /> Multi-Jurisdictional Violations to be Referred to : ❑ City Buildin /Code Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other <br /> Rooms inspected : Z � � �. � ^ <br /> Comments : 7iY � 10 <br /> - <br /> 1 t, Or IG <br /> r ' to Vr <br /> All violations in rooms not inspected m ' t also be corrected . <br /> All remirjspections by the Environmental Health Department will be billed at the current hourly rate . <br /> Received By : Title : L24 <br /> Environmental He It ecialist : one : 4,� 34 v HOTEUMOTEL OR <br /> EHD 24-01 4-30- 12 <br />