Laserfiche WebLink
q�!�r SAN JOAQUIN COUNTY <br /> a4• :..F%E .o <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ;2 <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facilit : Inspection Date: <br /> Address: PE: PR#: <br /> Owner/Operator: Phone: <br /> 5,l: 2 —1(4 6 <br /> [Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection Re-Inspection <br /> #Units in Facility: '31, 7#Units Inspected: I Reinspection On or About: J' <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, ,3tsV 3Os <br /> 1' garbage,combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- MOW aN 44n was <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 /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> 3' Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, iY`z►2 (Nv # ' <br /> working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). �QG <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. Nc -,eSx� S <br /> ❑ s 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 <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. <br /> Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards; Lack <br /> ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used? Yes ❑ No Company Name: c,i,,WFrequency: Mc6Y <br /> Hotel/Motel Business License? 0Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: [.City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: ;# -42/1 -y7i-t W3. I� ,Wlel,, ' 3dS�- <br /> Comments: JNAf0;I;f 1 t u'7 to <br /> " r <br /> ip da <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections by the E • on ntal Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specia is : Phone: <br /> LPaLge of <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />