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SAN JOAQUIN COUNTY Q ENVIRONMENTAL HEALTH DEPARTMENT : t 1868 East Hazelton Avenue , Stockton , CA 95202 - 6232 ON NOON Telephone: (209 ) 468=3420 Fax: (209) 464-0138 Web: www . slgov . orp /ehd J iFO :P HOTEUMOTEL OFFICIAL INSPECTION REPORT A � RN Name of Facility : 12EL T� Hore� Inspection Date : 0 S214 y Address : ,2y / N ✓18;v vOnaL/ w ✓ T. � .r'1�OGK n/ PE . Zy/ Wjw?� PR#_/LoZyDO(o0 Owner/Operator: Vl Phone : PRM //PP , Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re- Inspection # Units in Facility: 2 5 # Units Inspected : Reinspection On or About : 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 , xeti 6 garbage , combustible items or similar materials . Room Maintenance : General lack of repair or improper maintenance ; Broken or non- if (Lr l5� L3 61 L 2 functioning sink/toilet/bath ; Lack f hot water. Floors : Not clean , properly covered or in good repair. Walls & Ceilings : all ceilings in need of cleanin_Qpair: Holes , water damage , peeling or deteriorating paint ; Dampness or excessive moisture in room . ❑ 3 ' Heating : Lack of approved heating in each unit ; Approved heater not maintained in a safe , 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) . ❑ 50 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. ❑ Garbage Receptacles : Inadequate number of garbage receptacles ; Lack of or inadequate 6 , close fitting covers ; Garbage receptacles unclean or in disrepair. i ❑ 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 : rie6tricaV.1structural , or plumbing hazards ; Lack 7vrL>zi Cn.erf 1>0 �) 10. of or inadequate smoke detectors or fire ex ' ers ; Inadequate lighting ; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? 2rYes ❑ No Company Name : IWAI r 41-L s�q14J`N requency: OSI Ce r? ,vT Hotel/Motel Business License? ❑ Yes ❑ No Multi-Jurisdictional Violations to be Referred to : ❑ City Building/Code Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other Rooms inspected : 22 21 / 1S r . Ll l 3 3 Comments : f 22 — CLC89 (Loo0ti P/UO& Td 0ccvPrg74 (4 - � ZI ' p�FitjtC� fh/L �,H- -rrri� oN ftioo� flq NNRov1Ve in1s7MG AO00/1 ' P/toW0E M7"ZeIf � cih hOL � C� R9i.� 6� si�K ' / y - f4ov10 co"Pt'e?we� It All violations in rooms not inspected must also be corrected . All re- ins c i the Environmental Health Department will be billed at the current hourly rate. Received By: > Title: Environmental Hea 1419t : Phone: } � bF - Page 1 of EHD 24-01 4-30-12 HOTEL / MOTEL OR