HomeMy WebLinkAboutBlackburn Elementary School 440004 05 18 12.LS.pdfN C, Departmmt of Enivno=vit and lot Re cured
Division of Envirorariernal Health Score 915
Inspection of School Date of Ins IClig, 0 5 / 1 8
Status code A
Water IECommomy [j]Nor,'Tiansrent NOM Community
0
Tran$IeAl NOFW-COmnlUrifty Non-PuSu bliC Wafer ppk , R]
Wastewater System: FJ�Communjly F1t_,,j0n-,Sft Sysiern
Health D epaArnent 18
0 1 L Currend Facffity ID2018440004
Old Facility ID
Water sample taken to dW inspection Name Change
E1Y e % R1 No Re-k)spe(tjon VeHfic alion of Closese
Visit Status change
Location Address 4377 W NC 10 HWY MaWrigAd,dr.,
city. NEWTON state: NC zip. 28658 City: Stalin— Zip:
1. WATER SUPPLY, Approved water supply properly located,
constructed, and operated, adeqwte for all requirements 130*1 well
Rouse clean, no storage 15*-, no cross connections 30* (2405) 1— I'll r
175
2. SAITITARY SEWAGE DISPOSAL,- Sewage oo, flected, treated, and
disposed of by an approved method 150*,, system properly eperated
205
and maintained 55 * ( Z407) ........ ...
3. DRINKINGFOUNTAINS Clean, and in good repair 40#, adequate
80
pressure, prop erlyregulated 40# (24,06)_ ....... ... .. .. ........
,4. TOILET FACILITIES I Walls and ceflings, clean, nonabs orbent,
washable, and in good repair 30#b fixtures clean, and in good repay
100 15
40#, floors imp ery ious, kept clean 309 (2408)_
5. LAVATORY FACILITIES, Fixtures clean and in good repair 30#,, soap
and individual towels or approved hand -drying devices provided 40#
70
6 FLOORS: WALLS, AND CEILINGS, Floors, walls, and ceilings clean
e0 15
and in good repair 304(,2410.)
40 '10
7. STORAGE SPACES: Clean 20#, storage off floor 2L)#(.141 1)
8LIGHTING AND VENTILATION , Fixtures, grills, vents, blin,ft, drapes,
40
etc., clean and in good repair 4G#(Z41Z)_..... .. ___
9. DRESSINGROOMS AND SHOWERS: Flom, walls, and ceilings
clean, in, good repair, washable, non absorbent 30k, fixtures clean, in
good repair 40#, facilities for stern of cic-thes provided, kept clean 100
",#; soap, and towel 10* (2413)
10, SOLID WASTE DIImpervious, cleanable containers with
lids, approved type 20*clean ar
ty in good repai
r 70# — pfie ern s as 80
needed, prcperly disposed of 404 (2414)_........ 111--11, 1
11- PRELIISE& MISCELLANEOUS: Premises neat, clean 30#, novector
breeding or harborage 20#1 pesticides mid other toxic materials 80 10
properly handled and stored 30* (2415)
TOTAL 1000 50
Score commertts
Additional Comment SheetAtiached
S Y No
NHS 1896 - Sears, Limn
I
STR - 1014 w Genkaj se' G , St@ lute 130A -236 Wrft-- the C onunssion for Health Services to adopt rules goverrung the sarritation of public, private, and
f. b2' 'nsve andtv-v copies for: I Onginalto beleftuolthprincipal, 2 Copyforthelocal heWthilepartment, 3, Cor
in'e school TMb s, a , been devr aped to re Us �111 �,Jp I U ��dlhe results of such rnsp�bons. Prepaxabom Local environmenial health spa ciahAs shall mmplete ffic form
7:'c L.'sco every tune fliey conduct an inspe an A, fbr
the Environnvoilal Health Sem.ces Sedi on, Divik on of Emhrmniental Health- DisposifiPleaser—efer to Records RettiationandDisposition Schedule &B 6_
laspecticynRecords for Coon ty/DistictHeWthDepaitment,s%4ich,is iviblished by the North CarobaaDiviss on ofArcluves &History. A ddifiozial famsmay be ordered
Evora Divisim ofEnthronmentiHealth, 1632 Mail Serheel enter,Raleagi, NC 27699-1632,(Courier52-01-00)
DENR 1163 (Ronsed 7/051
Environmental H ealth Seri ces S ezh on (Rm ew 7a1 8)
N.C, Department of Environmentand Natural ResouCres NaMe, BLACKBURN ELEMENTARY SCHOOL
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COMMENT ADDENDUM
0; 2018440004
Street-, 4377 W NC 10 HWY
It: NEWTON,
ii� 11 P 111 1 J I 1 1111111 1, 1 '[�tji 11-111
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Time In- 0 0 0 1 a
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Time Out: 0 0 0 a [Ra
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Tota� Tne, 1 minute
N.C, Deparlment of Environment and Natura� Resourses
DMsion of Envininmental Health
ID, 2018440004
AA4Mjnl4klk,l"jl 910410191116
AT, =-. K97711UT-411TU
Street 4377 W NC 10 HWY