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PQ�,N SAN JOAQUIN COUNTY �o.• L�.coG E: RONMENTAL HEALTH DEPART_ =NT Q,• .-T�-,—. .y� as ly 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehl HOTEUMOTEL OFFICIAL INSPECTION REPORT Name of Facility: J ,jeICK7VA/ HOVIL IAJAJ Inspection Date: Address: / 3 ��. MSK J/j • 6LvD., f>bcxioL� --- PE—'yCf PR#. 2yc3 Owner/Operator: /VRrj�s-NK�H�L / ��i Phone: PJV /y/° ST-Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection # Units in Facility: # Units Inspected: I 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): ❑ t Room Cleanliness: Lack of cleanliness& sanitation; Accumulation of debris, trash, garbage, combustible items or similar materials. Room Maintenance: General lack of repair or im ro er-maintenance; Broken or non- �cG�A�T FIX ok �y functioning sink/toilet/ka ,- ack of hot wate loo Not clean, properly covered or in k S, +� 2. 0� repair ' &Ceilin 1 Wal;slceilings i eed of cleaning or repair: Holes, water trlor1 i>J damage, peeling or rlorating paint; Campness or excessive moisture in room. O��u ta,✓G1 ❑ 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). ❑ 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. ❑ 6 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? E-1 Yes ❑ No Company Name: L r PF.j' rjrh-0 envy: X 19- rlc-w r7l ?r3r ftMa 0, -> 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: ICS 121- Z(o -3 1. -•Z 13q ZZq Z3 Comments: 1 Lv— CW Ci WC'T ,r/NK c:zr&AAL7 ! c5<T To 2CM)U6 -ro i'294� IQ-1- C~E'is- „wu1.0 6E ( .ftaCD /fit. Hb M_ 1'22Y-VWC_ 61 WNDAIWI JWJK rL23 I ►- (. fer H*jty J tit- ktcr To baldxlL OWO GNIVV7 6j thxvr Ooo/L /AW flz&yc�q_ t32- VU%4, jhNr 61 W JS C446KCV 1 P+'gwN , Ct.W&.J OVCOs-011147)0,06) rni cEr--jot. G�1 r0owR47 to 1JIC 13y- y fr ung, l,] 6 y All violations in rooms not inspected must also be corrected. All re-inspections? by tile Ethvironmental Health Department will be billed at the current hourly rate. Received By:,.f- Title: Environmental Heigith pecialist: Phone: Yb - y� Page 1 of f EHD 24-01 4-30-12 ! ` HOTEL!MOTEL OIR