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apa�!>r. SAN JOAQUIN COUNTY <br /> �i� ENVIRONMENTAL HEALTH DEPARTMENT <br /> vdka, r.' 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility:,lM�OTC-�t_ nL #(616(c5 <br /> �.11f� (c J� Inspection Date <br /> Address: '�bC�, TJ ( 1' N , q6;-_V -7 PE: 4.09 PR#:�1 q L� 09 <br /> Owner/OperatoJr:Tn�L to PhoLn-e":TI2 19 _ 92 -1 —G( I ( <br /> F' Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-inspection <br /> jJ 1,0 <br /> # Units in Facility: j 2,2 # 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 /> ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> garbage,combustible items or similar materials. <br /> Room Maintenance:General ack oA�owater. <br /> r improper maintenance; Broken or non- 121 V191At%V) Gtth�� h <br /> 2 functioning sink/toilet/bath; Lac o Floors: Not clean, properly covered or in 1!j�CVY-4 nq <br /> good repair. Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water �1 <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 /> ❑ s Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ <br /> 7' Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other 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 Subslz <br /> u onditions: Electrical,structural,or plumbing hazards; Lack <br /> 10. of oNpequate smoke detectOr! Dr fire extinguishers; Inad hting- Inadequate <br /> protection from weather; Inadequate sewage or water facilities. 41q10 :q <br /> Pest control Used? 1K Yes F-1No Company Name: A n 11PE4 Frequency: j <br /> Hotel/Motel Business License? Yes El No <br /> Multi-Jurisdictional Violations to be Referred to:❑City Building/Code Enforcement/Fir%[]County Code Enforcement/Fire❑Other <br /> Rooms inspected:I b-+ pla1 12- 1 -3j16. 1 9 12 2-0 11S LI 13 2 �' <br /> Comments: 2 <br /> �� Thi n �� ���. sIr1Q � t � ems �� v .�• la � <br /> windowC in 4ion VaPAI r-tf'l <br /> d KAm ti� <br /> All violations in rooms not inspected Vnbst also be corrected. <br /> All re-inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: IA_ Title: <br /> Environmental Health Specialist: �C- Phone: Pae 1 of s <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OR <br />