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,opq t"•co SAN JOAQUIN COUNTY I <br /> c n <br /> r. ENVIRONMENTAL HEALTH DEPARTMENT 4DPAIL.f S'fA <br /> A 304 East Weber Avenue, 3b Floor, Stockton, CA 95202-2708 <br /> q, p Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ebd <br /> GIFOpa <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name o1 Facility: 1A i <br /> Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: OZ • Reinspection on or after: <br /> %f <br /> PJO t 0 1/• O CFS) 0 Other: <br /> 0 [dJ <br /> REC RCULATION EQUIPMENT The marked violations represent Health&Safes Code Violations and must be corrected as indicated: <br /> Filters (Z <br /> Pump e/ I �f��1eF,1���Q'//SS/it-ro <br /> ❑ Chlorinators , <br /> Cl Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters .2 - .O - T WA6EPLAJ <br /> ❑ Back Flow Prevention <br /> Main Drain Cover <br /> ❑ Equalizer Line Cover 5a Ep—�E <br /> CONSTRUCTION <br /> Pool Shell 11 M <br /> Fcncing/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 /> Chlor ne <br /> pH <br /> Cyanuric Acid <br /> Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ <br /> Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> �l <br /> Influent: ' !/ <br /> Effluent: Time In: ceived By: Inspected by: <br /> Time \ <br /> E EO (��S <br /> EHD 36-01 5/26/05 Page of� . <br />