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Pck y SAN JOAQUIN COUNTY <br /> '.. -fir~ ENVIRONMENTAL HEALTH DEPARTMENT <br /> i 868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> P <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: (`� JtMW I Inspection Date: 2,00 <br /> Address: 305 S - WM40'n Wa S1 V�IV► I q!j� PE241-7 PR#: b2/1 O-0L 1 <br /> Owner/Operator: (� -9/1 D sjq 'f1 rr Phone: &0 - 311 _`J' `"tom <br /> vX AAnnnuual Inspection e❑] Complaint Inspection ❑ Consultation Inspection ❑ Re-inspection �(I <br /> #Units in Facility: #Units Inspected: Qj 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. Room(s): <br /> ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> garbage,combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- oor-ir'18 6n <br /> �y( <br /> 2. functioning sink/toilet/bath; Lac c o o water. Floors: Not clean properly covered or in <br /> p� ood r air.Walls&Ceilinos:Walls/ceilings in need o cleaning or repair: oT,wafer <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, <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 /> ❑ 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 /> ❑ 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. ) ' 1 I A <br /> cr4rlu OVV--*l <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lackq(;y1� 4.0n <br /> ' <br /> F-1t'10. of or inadequate smoke detector�.or fire extinguishers; Inadequate lighting; Inadequate sw,nd 4&ean IN001� <br /> protection f om weather; Inadequate sewage or water facilities. — ns10�1 aZ— QIP t� 6mc�K¢ <br /> Pest control Used? &Yes ❑ No Company Name: ffftAtW <br /> Hotel/Motel Business License? ❑Yes No WIIAN6 tp )4 <br /> Multi-Jurisdictional Violations to be Referred to: ❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: IS-7 ,11ae. 1416, IfM 1913 , Z (w0ek @1Y'1 C�91 <br /> Comments: <br /> f-Ire E 011VWU 011Vn re lago- - -At are C)Kq <br /> 1 s a sc kov <br /> kAj S ve. n qtr fi I low r o' <br /> 6 kn' Q <br /> Ili A I violations in rQdms not inspected must also be corrected. <br /> All re-inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialist: Phone: 2` �gef <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OR <br />