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aP4�rN. SAN JOAQUIN COUNTY <br /> a` Ei ..-,ONMENTAL HEALTH DEPART, ..JT <br /> N. h :< <br /> 600 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: do'�00'f 0-4 -9 P"� Date: a-z-/ <br /> Address: 2-'0x6(41 �efvg-aiq City: S?z3e< At/ Zip Code: <br /> Owner/Operator: Rwm- ffi'A -5 Telephone: Z' Q <br /> Program Element: (�_ Program Record: pjQa�,a4/O Inspection Type: to r'n N6 <br /> 5r0� Flow Rate(gpm): pH: Chlorine(pp <br /> � Cyanuri A�(ppm): Temp: Reinspection on or after: <br /> Other: <br /> -E I C f��k O QrU,IPi11�E;Nl The marked violations represent Health&Safety Code Violations and must <br /> be corrected as indicated: <br /> ❑ Filters P1:0' 4 151'f9 U t,6 160 ' zoo S <br /> ❑ Pumps <br /> ❑ Chlorinator Ut n&f< ffsg5 ko ,C—n/ /5_5-Q<- <br /> ❑ Flowmeter <br /> El Gauges ! �� g"&E 15 /c�o� LUde•CrNG _ J2F�i4/� <br /> ❑ Skimmer&Gutters !} ND SS u 6 c - 'f i?RP5s r Z' <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover ilv W M6-TC-Q. IS �Rc>v ri�E F9 FFQ c <br /> 57ue,r <br /> ❑ Pool Shell _ Gvb/ZK r �G /}4 - ,0ii 7- r 5 0C-j+ -0 A/ n-rn.t <br /> ❑ Fencing/Gates (c'<I {u t45 r►uG, J�tl S/�r✓� FQ , �E l'�/ £ 15 <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains f~'t V11 /H? v74Q 1/�7 TSL y <br /> ,;::,SAFETY EQUIPMENT a //Lb�tIVE TABS IN S/°A 5�-IAI&7C9 6 T r Dr 5�-nri�c,E <br /> ❑ Rescue Pole <br /> ❑ Life Ring T(�r�7 #' 3AdTrx lWateD'�-� <br /> ❑ Safety Signs (f) �P� �l��Lv21 NE 790 HlGN <br /> ❑ Lifeguard D 7n T&57- <br /> [:1Pool/Deck Lighting Sr P , / O NaT k(- bf)---N u+tJTt 1 u 2,0 <br /> ❑ Ladders/Hand Rails f j' (NS tTZ4� 15 P A-R777x-N7- <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits T'/NSC �ST� CrS wc7�t Sr�ePE�E5 , �l'f}rR Fay <br /> ❑ Emergency Shut-off Switch <br /> ❑ Showers o5,,,,D> <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation <br /> 1���ATE:QVAW,t <br /> ❑ Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> �r <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: <br /> Received By: In petted by: <br /> Effluent: <br /> Time Out: <br /> EHD 36-01 7-31-09 SWIMMING POOL OR Page of I <br />