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..1 SAN JOAQUIN COUNTY <br />' A F •VIRONMENTAL HEALTH DEPAF IENT <br />--0 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: L.(� <br />Address: <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: <br />Inspection Type: V-AA1020 <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT -., <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />e <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />O r <br />? <br />O <br />❑ Gauges <br />❑ Skimmer & Gutters`H^p'a <br />❑ Back Flow Prevention <br />s <br />a <br />U464 <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />loam X& <br />!k& 0 <br />- <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />D.. <br />qv' <br />❑ Wade Pool - 2 Main Drains <br />SAFETY` RUIPMENT-".:. <br />Rescue Pale <br />_❑ <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />" <br />❑ Depth Markers/Tiles <br />�/jQ� y _ <br />�^ <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />. RESTROOMS <br />El Showers <br />/I,�,' <br />%t' 0.n <br />K/ <br />❑ Toilet & Dressing <br />❑ Ventilation <br />d <br />i <br />D ' <br />TER UAt.IT <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />❑ supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent:1Me�do 1. 1•� <br />Effluent: <br />Time In: <br />etve8 By Inspected by: <br />`7`kfLlvp%�(,/({)L }/ <br />Time Out: <br />EHD 3"17-31-09 SWIMMING POOL OIR Page -L of -L <br />