HomeMy WebLinkAboutBlackburn Elementary School 440004 05 11 10 KM.pdfN,C- Department of Environment and Namml Resources ore 94-5
D,�rsiou of EnvircraSc
ntntal Health - Health Department 18
Inspection ofSchool Date of 1nsp,'ChS'[fl:5] I [�E Current Facility ID 2018440004
Status codes A I Old faahtvlD
at ff]Commundy [Drion-Tianment r4on-Communfty Water sam pie taken todaY? tnspechon Name Change
IflTranMent Non-Cornmundy R] Non -Public Wale. r Supply Ely e S R] ti 0 Re-anspecton VerffiCafion of CIOSufe
Wastewater system: '(1]COMMUndy fflon-sft system visil Saujs Change
Location Addrm, 4377 W NC 10 HVVY 'Malling Addr,
City-. NEWTON State: NC zip: 28658 City: State, Zip.
Score Comments
1. WATER SUPPLY, Approved water supply properly located. SEC COMMeNT SHEET ATTACHED
constructed, and operated., adequate for all require maents 130*' well, 175
house clean, no storage 15*, no cross connectioris 30* (.2405) ----
2
collet
2. SANITARY SEWAGE DISPOSAL, Sewage ted, treated, and
disposed of by an approved snethod 150*, system properly operated '205
and rnaintaind 55* (. 2407)--.
3- DRINKENG FOUNTAIN& Clean arid, in good repair 4,0"*, adequate so
pressure, properly r" ..........
4, TOILET FACILITIE& Walls and ceilings clean, ticsiabsorbent
washable, arid ingood, repair 300; fixtures clean, and in good repair, It Is
floors impervious, kept clean 30='(.2408)
5. LAVAT ORY FACILIT MS: Fixtures clean, and in good repair 300"; soap
and individual towels or approved hand-tinying devices provided 400' 70
(-2409) ..... ........
& FLOORS, AlkALLS-, AND CEILINGS.- Floors, walls, and ceffirips clean :,0 15
and in good repair 30,d (,2410) .— ...... 40 '10
7, STORAGE SPACES, Cleanoff2O#, storage floor
S. LIGHTING AND VENTILATION, Fixtures,
, grills, vents, blinds, drapes,
etc., dean and in good repair 404 40
9, DRESSING ROOMS AND SHO%VERS: Floors, walls. and, ceilings
clean, ii good repair, washable., non -absorbent 304, fbxtures clean, in
good repair, 404i facilities for storage of clothes provided, kept clean 100
200, soap and towel 10*
10, SOLID WASTE DISPOSAL ° Impervious, cleanable containers Nvitb
lids, approved clears and in good repair 20i:l empties as so
needed, properhy disposed of 40-- (-1414)
11. PRETMTSES. MISCELLANEOUIS: Premises neat, clean 30#; novector
breeding or harborage 200; pesticides and other toxic materials so 15
properly baudled and stored 30* (�'1'41,
* .............
TOTAL 100,0 55
Additional Comment Sheet Attached
M;% 2259 E] Yes [j] No
LXSrRUCTION.6 Purpage—Genefal Statute IFOA-236 requires the Commission for Be do Services to adopt rules governing the sanitation ofpublic,
private, and religious schools- This form has been deselopand to record the results of such inspections, Preparation: Local environmental health
specialists shall coullolete the form eve;-, titne, tire;, conduct ai inspection, Prepare -an original and two copies for: 1. Origind tube I with A,
Fluor'l p
2. Copy fbr the local health department.3. Copy forthe Environmental Heaps Ses,ices Section, Di,,ision of Environmental Health, Disposition -
Please, refer to Records Retention and Disposition Srhedule S.B.6., Inspecticn Records fa County-°'Distriof Health Departments which is publishedby
the Nkirth C*ohna Division of Archives & HjSlof)°r Additional forms may be ordered froun; Division of EnvirlonmentaJ Health, 1632 Mail, $ervice
Ceraff, Rateigb, NC 2709-1632, (Courier 5-1-01-
DE NR 1163 (Revised 7!05)
Environmental Health Sm'ices Section (Rn�iew'708)
N,C, Department of F-nvironment and Naltwal Resourses NLACKBURN ELEMENTARY Tlir-ne in: Lfj a m
[j p rn
Division of'Env iron mental Heafth IID� 2018440004 Time Out:
[-]am
Street: 4377 W NC, 10 HWY Totall Tlirne; Elpm
COMMENT ADDENDUM It NEWTON
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