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SAN JOAQUIN COUNTY <br /> ENS,.- .ONMENTAL HEALTH DEPARTMI .4T <br /> #Iy 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd &I't <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: .v, <br /> Address: City: zip Code: - -23 <br /> Owner/Operator: n ^ <br /> Program Element: Program Record: Inspection Type:. D <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: <br /> RECIRCULATION EQUIPMENT . The marked violations represent Health &Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters 6 <br /> ❑ Pumps <br /> ❑ Chlorinator r <br /> ❑ Flowmeter 7 <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention / <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONST_R_ UCTI,ON <br /> ❑ Pool Shell <br /> ❑ Fencing/Gatesyt l (� <br /> [I Decking &Coping <br /> ❑ Wade:Rbol-2MamDrains <br /> SAFETY EQUIPMENT 4H -k f I I ===41 <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs K_ i11) / <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting i r G .? <br /> ❑ ElTd3dand Rails <br /> ❑ pth-Al rkers/Tiles <br /> ❑ iRrst�AMi <its AA <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS' <br /> ❑ i]OW11�5; <br /> ❑ ile t5ressing <br /> ❑ VZje laYj�n <br /> !-,W:EW QUALITY S X <br /> ❑ pH <br /> ❑ Cyanuric Acid �Y'V <br /> ❑ Clarity <br /> ❑ Test Kits <br /> --MISCELLANEOUS- <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae Ib <br /> Influent: A 1� <br /> Time In: ReI'c d By: n e by, �V <br /> Effluent: Time Out: <br /> EHD 36-017-31-09 SWIMMING POOL OIR Page i s <br /> of] <br />