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oPq�!►� SAN JOAQUIN COUNTY <br /> �` <br /> <. ENVIRONMENTAL HEALTH DEPARTMENT <br /> Z: err <br /> 1868 East Hazelton Avenue, <br /> Stockton, CA 95202-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> a <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: �{�D,� I�1 �� Inspection Date:e)U ` <br /> Address: b 0I l � `,M e-9 t ri f A552461 <br /> PE:�/t�1 PR#:0/402,91 0� <br /> Owner/Operator: P�.�11 Y11 t�'='�'Y/►I (L.,�r`- '—+H7jv "� Phone: am <br /> _ L --ZDlD <br /> Annual 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 /> Accumulation of debris m Ls-' rml a <br /> 1 Room Cleanliness: Lack of cleanliness&sanitation; ,trash, a <br /> garbage,combustible items or similar materials, <br /> Room Maintenance:General lack of repair or improper maintenance; Broken9r non po 1a1Yo -I In V_Cutroem. <br /> �( functioning sink/toilet/bath; Lack of hot water.Froors: Not clean, properly covered or in Imo-- Hbl•G VA s <br /> 1�! 2. good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repai Holes water k4�-V1�� tn�� <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in m. <br /> ❑ s 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 /> ❑ 5 Bedding: Mattress/linens infested with lice,bedbugs,or other insects; Not free from filth or <br /> 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 /> 7 Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other POD f)Q-r YYL1 vw) \Ut <br /> publicly shared spaces. emn INa{PY <br /> ❑ 8. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. �3 <br /> Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazar s; Lack <br /> 10. of or inadequate smoke detectors or fire a Ingulshers; Inadequate lighting; Inadequate ].Qtj (_Anl It MI SSI <br /> protection from weather; Inadequate sewage or water facilities. ff''-�idd P.KC je ;Rem eAQ <br /> Pest control Used? Yes ❑ No Company Name: y) Frequency: <br /> Hotel/Motel Business License? XYes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: ig-ca 014o, 2 P3 ZZ-7 14b 520 33 a <br /> Comments; <br /> aint61n q�tn o ch ai I rm mss• M itIatAir afh0 al e <br /> aild Ut a & AU Ivi lit I vQ <br /> *smh o <br /> v eC <br /> All violatfdns in rooms not inspected must also be corrected. <br /> All ins ions by the Environmental Health Department will be billed at the current hourly rate. <br /> ReceivedB , Title: <br /> Environmentaf ialist: F) Phone: - Page 1 of <br /> EHD 24-01 4-30-12 22// H07EUMOTEL OR <br />