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HOT OTELOEFICAL INSPECTION 'ORT
<br />'an Joaquin County Public Health Services
<br />Environmental Health Division (209) 468-3421
<br />304 E. Weber Avenue
<br />P.O. Box 388, Stockton, CA 95201
<br />A 1.... 1 1 , -I- ,-- DB/NAME
<br />C. Ci q __ vr --, 1 -5 „t- ("•\(--.4., c ('
<br />_
<br />TEL I
<br />' F_3C:
<br />DATE
<br />ADDRESS ...., .._, I ,---) 1 SWEEPS
<br />.L. . I, /1„) . 1 ( c ( , ../ i 4-, I tl ri . 77c, r \/
<br />NUMBER
<br />OWNEROPEFIATOR r•-• r - 7--
<br />
<br />- — yv- •
<br />TEL ( ) TIME OUT
<br />,
<br />TIME IN
<br />MAIUNG ADDRESS
<br />PROGRAWF1.EMENT
<br />
<br />SERVICE -- 1.'
<br />
<br />4- ,ci - i /
<br />TRANSFER DATE
<br />FAcuTlES OPERATING vemour A VALID PERMIT ARE SUBJECT TO CLOSURE. TRANSFERS Cf OWNF_RSH)P NOT REPORTED wiTHN THIRTY r30) DAYS FROM THE
<br />RECORDED DATE Cf TRANSACTFON ARE SUOJC-CT TO THE BASE PERMIT FEE PLUS 100x PENALTY.
<br />PUBUC AREAS The marRed items represent Health Code Violations and must be corrected as follows:
<br />MAN STR
<br />Elect. Wiring I 2
<br />Plumbing 3 4
<br />Foundation 5
<br />,I./-K),' ((ir,
<br />6. r 1 j
<br />Plt. 4. il,",u (' 1,7Y? . 91 if ,, --Y.ft I r'' ( I 1z2(:,,i/tif - Fire Safety 7 6
<br />1.4ech. Equip. 9 10 ( 1
<br />±,. (7e.- CO n.' Floors 11 12
<br />Roof 13 14
<br />. ExL Walls 15 16
<br />Int Walla/Coil. 17 le
<br />Stairs 19 20
<br />Toiliellatris 21 22
<br />I I ,-. / /
<br />(-1<.. --r- (,-; • .; (- M H, f -i- c, ,/,, c.• — ,,, 6, - • r-H-'r ,,:(!--71 1 -;lz) I / q ,t,-• , ' r 1 Ught & Venc 23 24
<br />,
<br />Ocean/Icy .//:,' 26 i
<br />-.
<br />! ) , / i .,- - /
<br />-
<br />. 1 7i -/ i i") , / 1-C471-11 1 V• rmin 27 28
<br />Realm 29 30
<br />Pool 31 32
<br />UNITS 1 1— 1 •
<br />\ ' ,. , rYt 1- 'fr) Ts' I -(...; i) r ( (. ‘ 7 f: -1- f 1E' ,--1--
<br />II f 1 1 i , --- / i 74 L1.16,,
<br />_ _., . . , (---• ('.--,' / — 1 I '77" / ( / r"-- //‘-' ••.' tr(L 4.-e.-7 ,v, i ', Sam Winrig 33
<br />Plumbing 34 i / ' •
<br />Fire Saw/ as
<br />Floors 36 ,
<br />L ), 'i i --1 c
<br />1 ,
<br />4 to -I , _4/
<br />r'') rc,L , i-1 !-1 C , ---•,(- , , .,- / , , a • ' 1 r , WallsColings 37 ,
<br />Light & Vont. 38
<br />Ocameno/ 39 ,
<br />V•nylin 40
<br />H .1 C Water 41
<br />Toilets 42 '
<br />• 14sat 43
<br />Sinks 44
<br />Battu 45
<br />Cook 4ei
<br />Mernenanai 47
<br />Furnishings 46
<br />1 49 TOTAL
<br />NUMBER UNITS INSPECTED
<br />ENVIRONMENTAL HEALTH PERMIT AND SERVICE CHARGE FEES ARE
<br />RE INSPECTION DATE:
<br />50
<br />AUTHORIZED BY SAN JOAQUIN COUNTY ORDINANCE. ALL DOCUMENTED
<br />IMMEDIATE HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT
<br />UNPAID
<br />E
<br />
<br />Fgr.. :
<br />
<br />, SA A CLASS
<br />_R.-
<br />TO A REINSPECTION AND REINSPECTION FEE. ALL CHARGES
<br />ASSOCIATED WITH THE FACIUTY OWNER OF RECORD OR APPUCANT
<br />SHALL BE PAID PRIOR TO ThIE ISSUANCE OF A PERMIT TO OPERATE.
<br />
<br />,-/,-, --F --7- 1-f i(j (-u
<br />,
<br />ENVIRONMENTAL HEALTH SPECI.M.
<br />-7,14 1 ,-/,:-/
<br />A a t
<br />PAGE —
<br />PHS on - 1 84 (7/96)
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