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SAN JOAOUIN COUNTY <br /> Q` - ''•Z� Er -�ONMENTAL HEALTH DEPART NT <br /> ".Yllll_L ' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> _�.P Teleph <br /> .: one:(209) 468-3420 Fax:(209) 468-3877 Web:www•s1gov.org/ehd <br /> .FOR <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> _ Date: �t I <br /> Name of Facility: C <br /> I a City. `IYG� y Zip Code: <br /> Address: � I S �, f Telephone: <br /> Owner/Operator: TU J n <br /> 6 CJ 15`•I Inspection Type: AQP, J ; <br /> Program ElemeProgram Record:nt: ,3 6 g Reinspection on or after: <br /> Flow Rate 1gpcm): pH: <br /> Chlorine(ppm): Cyanuric Acid(ppm): Temp: <br /> ( ,/t <br /> T I 7 rL. 5.1) (-t- -0-j- �/ +P Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health& SafetyCode Violations and must be corrected as indicated: <br /> ❑ Filters - - - — a/1 -- <br /> ❑ Pumps <br /> ❑ Chlorinator -_ U C P G tl n <br /> ❑ Flowmeter5 ' G <br /> i ei rf e 11 ' <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters �C'fill. <br /> ❑ Back Flow Prevention - <br /> ❑ Main Drain Cover, - <br /> ❑ Equalizer Line Cover - ---------- <br /> CONSTRUCTION <br /> ❑ Pool Shell - <br /> ❑ Fencing/Gates - <br /> ❑ Decking& Coping - <br /> ❑ Wade Pool-2 Main Drains - _ -- <br /> SAFETY EQUIPMENT _. <br /> ❑ Rescue Pole <br /> ❑ Life Ring - ---- — --- - -- - <br /> ❑ Safety Signs - <br /> ❑ Lifeguard - - <br /> ❑ Pool/Deck Lighting - <br /> ❑ Ladders/Hand Rails _ <br /> ❑ Depth Markers/Tiles -- -- --- -- <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS -- --- --_ --- ----- _ <br /> ❑ Showers -- -- -- - -- -- ---- <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation -- — <br /> WATER QUALITY <br /> ❑ Chlorine <br /> ❑ pH - - --_ -- - <br /> ❑ Cyanuric Acid <br /> ❑ Clarity - -- <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ Supervision & Control - - - — <br /> ❑ General Sanitation <br /> ❑ Algae - - - - - - - - - <br /> Influent: � 2 I � � f l 2! /i; ----- -- -------- - - - - - <br /> ` 1 Time in: �U �, Received By: Inspected by: <br /> Effluent: <br /> Time Out: j ��'Vl � /�!�✓�� S"p, - L <br /> EHD 36-01 5-8-12 SWIMMING POOL OR <br /> Pax <br />