Laserfiche WebLink
pop" y SAN JOAQUIN COUNTY <br /> Z: •Gy ENVIRONMENTAL HEALTH DEPARTMENT <br /> a � <br /> goal 1868 East Hazelton Avenue , Stockton , CA 95202 -6232 <br /> NK <br /> ' Telephone: ( 209 ) 468 - 3420 Fax: (209 ) 464 - 0138 Web. www . sigov . org /ehd <br /> 4�,• FOR INSPECTION REPORT <br /> —� HOTEL/ MOTEL OFFICIAL <br /> Name of Facility : �j ,� Inspection Date : <br /> ((��VV1I <br /> Address : ib SL S li �� ivPEZ � {� PR# : /l � ' �� C <br /> Owner/Operator: } �` in tri 4 .ry1 /1 9r P c 5 <br /> Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re- Inspection <br /> # Units in Facility : s1.. , 1 # 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. Room ( s ) : <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- <br /> functioning sink/toiletlbath ; Lack of hot water. Floors : Not clean , properly covered or in <br /> 2 . <br /> good repair . Walls & Ceilings : Walls/ceilings in need of cleaning or repair : Holes , water <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 /> ❑ <br /> Bedding : Mattress/linens infested with lice , bedbugs , or other insects ; Not free from filth or <br /> 5 ' 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 /> ❑ Public Areas : Unsafe or unsanitary conditions in kitchen , hallways , stairways , exits , or other <br /> 7 ' 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 . <br /> Other Substandard or Unsafe Conditions : Electrical , structural , or plumbing hazards ; Lack ' U !'llli 'X ►� � <br /> 10 . of or inatlequa}e smoke detectors r fire extinguishers ; Inadequate lighting ; Inadequate » rEFlu (1 sM� � <br /> protection fro *weather; 'lnadequate sewage or water- facilities . <br /> Pest control Used ? Wes ❑ No Company Name : (, ' U �, Frequency: m in <br /> Hotel/Motel Business License? AYes ❑ No �' e5 If Z60$3 <br /> Multi-Jurisdictional Violations to be Referred to : ❑ City Building/Code Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other <br /> Rooms inspected : <br /> Comments : l (S OK t. y t <br /> N} t <br /> A�AIT <br /> to [se 14 <br /> t <br /> All violations in rooms not inspected must also be corrected . <br /> All reminspectioniq by the Environmental Health Department will be billed at the current hourly rate . <br /> Received By : Title : <br /> Environmental Health Specialist : �/� r i1 Phone : Page 1 of <br /> vl <br /> EHD 24-01 4 -30- 12 HOTEL/MOTEL OR <br />