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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)468-0333 Web: http://www.sicehd.com/index.htm] <br /> CONTINUATION FORM Page: 3 of 3 <br /> OFFICIAL INSPECTION REPORT <br /> r127 <br /> 473 W Hammer Lane, Stockton ®ate:� 6/o/Z.vtf <br /> Program: 2-vt;0 <br /> SUMMARY OF VIOLATIONS <br /> currently occupied and has been occupied for 2 weeks, according to owner/ <br /> inspected. <br /> oom — Room currently out of service and being used for storage of dirty/soiled box springs. <br /> 2 dead bed bugs found next to the refrigerator; no live bed bugs observed on the furniture. <br /> There are mattresses and a couple of box springs in the back of the facility. The mattresses and box <br /> springs are ready for disposal, according to owner/operator. <br /> At this time, the EHD has not received any documentation re: disposal, new/replacement mattresses, <br /> and pest control company receipts for bed bug treatment(s) from the facility owner/operator. <br /> CORRECTIVE ACTION: <br /> 1. Clean/sanitize or replace all dirty/soiled box springs and/or mattresses. <br /> 2. Call Pest control company for treatment of roaches in room 108 and all adjacent rooms in all <br /> floors (see sample rooms below). Provide documentation to the EHD. <br /> 3. Vacuum carpet floor covering in rooms, including all corners and behind furniture and appliances <br /> 4. Clean and/or repaint walls <br /> Sample rooms 109 107 105 209 207 205 309 307 305 <br /> 110 108 106 210 208 206 310 308 306 <br /> FIRST FLOOR SECOND FLOOR THIRD FLOOR <br /> Failure to take these actions will result in the case being referred to the City of Stockton Hotel/Motel <br /> Permitting for further enforcement action. <br /> ALL EHD STAFF TIME ASSOCIATED WITH THIS CASE IS BILLED AT THE CURRENT HOURLY RATE($125.00). <br /> THIS FACILIT S SU ECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title: <br /> /�G11CitiG J� <br /> CONTINUATION FORM <br />