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oP0.UI SAN JOAQUIN COUNTY <br /> ENviRONMENTAL HEALTH DEPARTMtNT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> •0 Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.orglehd <br /> CfKp M <br /> •L� <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT VVV <br /> Name of Facility: L Date: !� <br /> Address: City: Zip cod <br /> e: �7 <br /> OwnertOperator: n <br /> Program Element: Program Record: Inspection Type: d e�o <br /> Flow kate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: <br /> REGif <br /> Filters <br /> t0�1 �c1tf;IpAiI;EI�T The marked violations represent Health&SafetyCode Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps <br /> ❑ Chlorinator <br /> ❑ Flowmeter 7 <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention - <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> " : � ` ro <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates 1 J <br /> ❑ Decking&Coping IF V <br /> ❑ Wade Pool—2 Main Drains <br /> r -FTE:Q 'IE:N`� <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs ♦ / <br /> ❑ Lifeguard Q r <br /> r 7 <br /> ❑ <br /> Pool/Deck LigwA a&A—� <br /> ❑ Ladders/HN, i <br /> ❑ Depth M leer's '1 <br /> ❑ First itsvk'u.Old <br /> ❑ ErFg 'n. ut-off Switch <br /> .52)X C1 o n e&c k <br /> ❑ Showed � <br /> ❑ Toilet''& Dressing <br /> ❑ Ventilation <br /> ❑ Chlorine S X <br /> ❑ pH \ <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> ❑ Su ervision& Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: <br /> Time In: Rec d 8y: Wn eEffluent: <br /> Time Out:IL- <br /> EHD 36-017-31-09 SWIMMING POOL OIR I V i� Page i of� <br />