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o�q!"•>y. SAN JOAQUIN COUNTY �'�'•' err .yZ ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: 1Q 14n AZ Inspection Date: Gt I1 Address: y � f PE: PR e "'1"" Owner/Operator: pa ,, 1 ,� l " I t S Phone: nnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: #Units Inspected: 1 Reinspection On or About: ej The items checked below are violations to be corrected. See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): 1. Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, Q la—5i id,r1oj ckxN' -}-o garbage,combustible items or similar materials. krm"k, ocwv,-diO4 Room Maintenance:General lack of repair or improper maintenance; Broken or non- )LA-2 — 5.1x,1 h 0V1(—a—+ 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 15v good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,waterwe� 1no►5 c.�raC ft damage, peeling or deteriorating paint; Dampness or excessive moisture in room. 15 S—� ,v.- Y-^ i ll Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, ❑ 3, working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). Drinking Utensils&Ice Buckets: Not protected from contamination; Lack of or improper ❑ 4. washing&sanitizing after each use(multi-use); Lack of or improper protective bagging (multi-use)or individual protective wrapping(single-use). ❑ 5 Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ s Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate close fitting covers;Garbage receptacles unclean or in disrepair. ❑ 7. Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other publicly shared spaces. ❑ 8. Pest Control: Infestation of insects,vermin or rodents. ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards; Lack ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather: Inadequate sewage or water facilities. Pest control Used? Yes ❑ No Company Name: Frequency: cA) ay- Hotel/Motel Business License?Kes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑ Other Rooms inspected: el I Ll 2 ILILI 11-15 1 '1 d I 5LA 15 r. Comments: pt�Wl S G•�+ -vlt.� — Int I -`�w1ia1 r1 - CO 0OCI, u All violations in rooms not inspected must also be corrected. All re-in ctions by the Environmental Health Department will be billed at the current hourly rate. Received By: Title: T-vV i,1t 0 /'l,� y Na - Environment ealth Specialist: I Phone: ��' / �tJa Page 1 of 14MEHD 24-01 4-30-12 HOTEUMOTEL OR