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o;4'CL c SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: �I 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.slgov.orq/ehd <br /> �1FOR/ <br /> .r / HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: v�. Inspection Date: 03 Zg/� <br /> G/IEJ'r� M CL <br /> Address: W3� WILD-0AI dt/17y� ;r'j1�G/�7viJ PE Zy�(p PR#. U2yUO2 <br /> Owner/Operator: Phone: <br /> 617W V CTH R19 Tfct <br /> JR_ nnual Inspection ❑ Complaint Inspection El Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: /S I # 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. Rooms): <br /> ❑ Room Cleanliness: Lack of cleanliness& sanitation; Accumulation of debris, trash, <br /> 1" garbage, combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- 2' C/W&r <br /> fun cti In sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in fWvtor l0l�L X'k Ub/17 <br /> 2" odR repair,Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water fi)cTvIL6I- <br /> a age,peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> ❑ 3 <br /> 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 /> ❑ <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 /> E] 7. Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other <br /> 7" publicly shared spaces. <br /> ❑ 18. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ j 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 /> PestcontrolUsed? V Yes ❑ No Company Name: ')r1Tnr r-fr Frequency: R n >N <br /> Hotel/Motel Business License? ❑ Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire ❑ Other <br /> Rooms inspected: 3 , 2- <br /> Comments: <br /> Comments: o-ty,Np4j �j'Ul&,�4 Ir! 6/3'14UO Ll n-r dol ' & Covgx 6y Hlmvlt <br /> - AW0126 CVvM 7D &Ibrfr r7XR#k-- 6 )916, 1011`1 At* h4P&I <br /> �( vC+/1�►f! 0l/1d"1 >r'1�2I C�cv 14 ILVOIIf /-01- P-;fr6t•7C0_7t <br /> All violations in rooms not inspected must also be corrected. <br /> All reins ections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialist: Phone: <br /> Page 1 of <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OIR <br />