HomeMy WebLinkAboutBlackburn Elementary School 440004 05 08 13.ls.pdfN,C, Department. of Envinanmetit and Hatizal Resources
DrIAsion of Environt'nentall. Veafth Score 96.5
Inspection ®f School Date of Insp/Chg: 0 5 / 0 8
Status Code-, A
Health D epartment 18
2 0 1 3 1 CruTeriffacility ID2018,440004
0 1 d Facility ID
Water WCommunity L3JNon-Transrent Non -Community Water sample taken today? [j][rispettion Name Change
MTransient Non -Community QNon-Public Water Supply Elyes R1 No 2 Re-insp"tion Verification of Closure
Visit Status Change
Wstern Ater aSystem, c FI]o, mm unity fflon-siteSyslem M
state: NC zip: 286,9W-'
Ma ih ng Ad dr .
City: State: Zip::
Score contments
1, WAT ER S UPPL Y I Approved water supply properly located,
constructed, and operated, adequate for all requirements 130*, well 175
house clean, no storage 15*;, no cross connections 30* (2405), . ..... _
2, SANITARY SEWAGE DISPOSAL-, Sewage collected, treated, and
disposed of by an approved method 150*, system property operated 205
and maintained 55* (2407)
3, DRINKING FOUNTAIN& Clean and in good repair 40#, adequate 80
pressure, properly regulated 404 ( 2406,) ....... _ ........ _ - __ ....... ____
4, TOILET FACILITIES , Walls and ceilings clean, nonabsorbent,
washable, and in good repair 30#-, fixtures clean and in good repair 100
40#; floors impervious, kept clean 3 0# ( 2408) ................................
5, LAVATORY FACILITIES: Fixtures clean and in good repair 30#, soap
and individual towels or approved hand -drying devices provided 40# 70
(2409)
6, FLOORS, WALLS: AND CEILINGS: Floors, walls, and ceilings clean 30 15
and in good repair 30# (2410) 40 20
7, STORAGE SPACES , Clean 20#, storage off floor 20# (2411) .......
8, LIGHTING AND VENTILATION: Fixtures, grills, vents, blinds, drapes, 40
etc., clean and in good repair 40# (2412),__
9, DRESSING ROOMS AND SHOWERS : Floors, walls, and ceilings
clean, in good repair, washable, non -absorbent 30#, fixtures clean, in
good repair 40#, facilities for storage of clothes provided, kept clean 100
ZO#, soap and towel 10* (2413) ..................
I OSOLI1i WASTE DISPOSAL, Impervious, cleanable containers with
lids, approved type 20*; clean and in good repair 20#; empties as 80
needed, properly disposed of 4( 2414) __. ................ .......
I I . PREIs4ISES: MISCELLANEOUS: Premises neat, clean 30#,, no vector
breeding or harbotWe 20#, pesticides and other toxic materials 80
properly handled and stored 30* (2415) ............... ......................
Insp
TOTAL 1000 35
EHS 1896 - Sears, Luke
Additional C otrurnent Sheet Attached
D Yes K No
INSnk2;;oI Ptirp Sh(ute I 1�11A22"I"prires the Comirassion for Health Senrices to adoptrules governing the sanitation of public, private, and
me
to
religious schools- 11,, Zrm�h,, b,,�n�� to rec, �d the results of such inspections. Preparation- Local environmental health specialists shall complete the fbrm
every nine they conduct an inspection, Prepare an onginal and tuna copies fon 1, Original to be left vmth principal, 2. Copy for the local health department, 3, Copy for
the Environmental Health Services Section, Division of Environmental Health, Disposition Please refer -to Records Retention and Disposition Schedule 8-B 6, ,
Inspection Records for County/District, Health Departments winch is published by the North Carolina Division ofArchves & History, Additional forms may be ordered
tiorn: Divion ofEnvironmental Health, 163 2 Mail Service C enter, Raleigb, NC 27699-1632, (C ouher 5 2-0 1 -00)
DEM 116 3 (Revi sed 7/0 5)
Environmental Health Services Section(Review7M)
K0. Department of Environ men t and Natural Resources Narne� BLACKBURN ELEMENTARYSCHOOL
Division ofErivironmental Health 0018440004
Street, 4377 W NC 10 HWY
Time In: 1 1 1 1 [E a
El P
Time Out, 1 1 5 ga
I E] P
Total Tune` 4minutes
N.C. De Da rm G nt of Envi -o n-n ent and Natural P es ours � s
Di-visicn cf Environmental Health
Nome: BLACKBURN ELEMENTARY
lll.f 'writ 11
ID 2018440004
Street 4377 W NC 10 HWY
CI -If: NEWTON