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`C PgUIN O SAN JOAQUIN COUNTY <br /> �� EI ,<ONMENTAL HEALTH DEPART AT <br /> 600 East Main Street Stockton CA 95202-3029 <br /> Telephone: 209 468-3420 Fax: 209 464-0138 Web:www.s' ov.or /ehd <br /> ��IFOR� Te/e�h• ( ) ( ) 1� <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: [j,(11Ot, G . Date: �— <br /> Address: 7.; City: Zip Code. <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: 1C <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection od or after: <br /> Other: <br /> REC,IRCUL" TIO, EQUIPMENT`j:, <br /> Thje marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters �'I'> , � <br /> i%Lxom 14- <br /> El Pumps I <br /> ❑ Chlorinatorl.J �►+N� <br /> ❑ Flowmeter % i' f •' <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention '714 <br /> El Main Drain Coverl' � <br /> ❑ Equalizer Line Cover <br /> *x<.CONSlRUC1ION4k !<`s !' In+Q, � <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool—2 Main Drains <br /> I`;=S'AFETcY EQUIPMENT, <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs i 1 LU <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails I <br /> ElDepth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emerge_. y Shut-off Switch <br /> ❑ Showers 1h4t 1-e4 ►'a <br /> ❑ Toilet&Dressing M <br /> ❑ Ventilation <br /> QI ALITY ; �Q I <br /> Y `�riWAJER,. <br /> ❑ Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid PLllk_ <br /> ❑ Clarity <br /> ❑ Test Kits 'w <br /> ❑ Supervision&Control <br /> ElGeneral Sanitation l:k - <br /> ❑ Algae <br /> Influent:, <br /> , <br /> Time In: Received y: J}� j�p cted by: <br /> Efflu4Time Out: > z(f`11 (/ C i V 3 3 <br /> 36-01 7-31-09 SWIMMING POOL OR Page I of I <br />