HomeMy WebLinkAboutBlackburn Elementary School 440004 05 05 16.LS.PDFN,C. Deparunent of EnNironment and Natural Resowws 97.5
Division ofEnvironmental Health Score ---------- --
Inspection of School Date of Insp.,"Chg', 0 5 / 0 5
Status Code., A
health Department 18
-2 0 1 6 Current Faciliirr• ED2018,440004
- 101d Facility M ,
Water MCommunity I i
j No n- T ran sient N on -Co rnm u nity Water sample ■taken tottay? Name Change
]NIon-Public Water Supply No Re h:n
Ely e s 91 5�8:p
[:]Transient Non-Community■in oil, n Verification of Closure 1
W a stew ate r S y a tern; EflCommunity it i
_Bon -site System Visit Status Change i
�=W'
state: NC zip: 28658 City-,
Mailing.Nddr.
1. WATER SUPPLY: Approved water supply properly located.
constructed, and operated, adequate for all requirernents 130'*; well 175
house clean, no storage 15*; no cross connections 3 0* (.240-15) ...
2. SANITARY SEWAGE DISPOSAL, Sewage collected, treated, and
disposed of by an approved method 150*: system properly operated
1 1 205
3. DRINKING FOUNTAINS- Clean and in good repair 40#'-, adequate
so
pressure, properly regulated 400 (2406) .... ............ ......................
4.'TOIL ET FACILITIES: Walls and ceilings clean, nonabsorbent,
washable, and in good repair 30#; fixtures clean and in good repair 100
4041- floors impervious, kept clean 300i (2408)
5. LAVATORY FACILITIES, Fixtures clean and in good repair 3041- soap
and individual towels or approved band -drying devices provided 400' 70
('2409) - ..............
6, FLOORS- WALLS: AND CEILINGS: Floors, walls A ceilings clean an 30 15
and in good repair 30# (2410) 40 10
7. STORAGE SPACES.- Clean .10'F, storage off floor 204 (2411)
S. LIGHTING ANENTILATION, Fiat ure& grills, vents- blinds. drapes-
40
etc., clean and in good repair 404 (2412) ......
Mate: Zip-
Scom Comments
9. DRESSING ROOMS AND SHOWERS: Floors, walls, and ceilings
clean, in good repair, washable, non -absorbent 304'- fixtures clean, in
good repair 40#'; facilities for storage of clothes provided, kept clean 100
204, soap and towel 10* (2413)...
10. SOLID WASTE DISPOSAL: Impervious, cleanable containeTswith
lids, approved type 20*; clean and in good repair 20#; empties as 80
needed,, properly disposed of 4N,
11. PRENESESI- MISCELLANEOUS- Premises neat, clean 304,"; novector,
breeding or harborage 200'; pesticides and other toxic materials 80
properlyhandled and stored 30* (2415)
TOTAL 1000 25
Additional Comment Sh X teach
y 0,
Inspection by; ]PL&OO es, WN'
-4Cff-f7-"'1kL ---- EHS 1 W6 - Sears, Luke
D�STRUCTIONS se, General Statute B& 236 requires the Comass on, Par health Setvives to adopttules goverriing the sanitation of public, private, and
religious school farm has been developed record the. results of such insliectims, Proparad= Local emironmental health specialists shall complete the form
ei.,-ery timethe or an inWcfion. Prepare, original and t%vo copies for: 1. Ciriptial to be, left mth prindpaL 2, Copy for the local health department- I Copy for
the kriviro t e ices Section, D ion of Emironmental Health. Disposition: Please refer to Records Retention andDisposition Schedule, 83 .6,,
Inspection Re ds for Ccun'7 epartatents which is published by the North Carolina Division of Archives &,history, Additional forms maybe ordered
from: Division ofEnvirorunentalHealth, 1632Mari Sere ictCenter,Ralei'gb,-.\,,C 276-09-1632,(Coutier52-01-00)
EHS 1163 (Revised? t}al
Environmental Health Services Section (Rrvievv 7,08)
N,C, Department of Environment and Naturaf Resources Name: BLACKBURN ELEMENTARYSCHOOL
Division of Environmental Health 01 2018440004
Street 4377 W NC 10 HWY
PAINT DOORS AND WALLS AS NEEDED.
Time 1w 1 1 0 0 IF
IF
Time Out: 1 1 5 0 91
El
Total Time: 50 minutes
N.,C. Department of Environment and Nalurat Rescurses
DrOsKn cf Envaronmental Heafth
'MaTTEMMOMMMM
Nsme: BLACKBURN ELEMENTARY
%zf 'writ 11
ID 2018440004
Street'. 4377 W NC `O HWY
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