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SAN JOAQUIN COUNTY - — -� <br /> E17VTR0 <br /> NMENTAL HEALTH DEPARTME <br /> 1868. East QGktQA 5-6232 <br /> one:(209) 468-3420 Fax:(209) 468-3877 Web:www.sjgov.org/ehd <br /> INSPECTION REPORT <br /> Name of Facility: <br /> Address: l '!0 , City: D <br /> Zip Code: <br /> OwnedOperator: [' 1 4 � � <br /> ��� Telephone: <br /> Program Element: 3 Program Record: <br /> Flow RateS Inspection Type: ` <br /> (gPm) pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: � <br /> Other: <br /> f#?Cit 11: Fi 1f ?F> The marked violations represent Health&Safet Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps COt.-'�- -� _&elkf7 12GC/ Gi <br /> Chlorinator <br /> CG PV <br /> El vi `Q mit <br /> ❑ Flowmeter <br /> ❑ Gauges A Zrlr7G ��G �I GG1j�/J / fG� <br /> ❑ Skimmer& Gutters C <br /> ®L[ <br /> ❑ Back Flow Prevention ; <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover ( F <br /> ❑ Pool Shell <br /> ❑' Fencing/Gates - ------- —�_.� <br /> ❑ Decking&Coping <br /> ❑ Wade Pool–2 Main Drains 11Gc LV, <br /> S31T ` <br /> ❑ Rescue Pale <br /> ❑ Life Ring ` ` "n <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting '6V <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth MarkerslTiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> ❑ Chlorine <br /> ❑ pH f <br /> ❑ Cyanuric Acid 2, Gam' — a F /' �r iila'��rwfL �► -Cil ��Ul�r <br /> ❑ Clarity <br /> ElTest Kits <br /> ❑ Supervision&Control r <br /> ❑ General Sanitation jtfA Q�� �- <br /> ❑ Algae Or I} , <br /> Influent: <br /> Time In: Rec ved y: Ins cted y: <br /> Effluent: Time Out: <br /> EHD 36-01 5-8-12 SWIMMING POOL OIR Page of <br />