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,qp4 `"•.s, SAN JOAQUIN COUNTY ll� <br /> ENV1ltONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fac: (209)464-0138 Web: www.sigov.org/ehd <br /> 9[IFO0.e\ <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: Z 1w 114401 City: <i0=2 <br /> Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: 2 Program Record: Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> 4 t A a«�, ADD ! Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> Filters I Z <br /> Pumps 0O/ V� /Tao kS <br /> Chlorinator <br /> Flowmeter C(/�j�, / /��� <br /> Gauges ��6/'i-�- Auto +�-s_w � /011 Ip <br /> ❑ Skimmer&Gutters ' <br /> E] Back Flow Prevention <br /> Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION' <br /> Pool Shell <br /> Fencing/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 G_es%L&,,,�-o nk Leo <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markersfriles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> WATER QUALITY <br /> Chlorine <br /> pH <br /> Cyanuric Acid <br /> Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS coo <br /> ❑ Supervision&Control �Y <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: Z <br /> Timeln: Nc� ped R Inspected by: <br /> Effluent: <br /> Time Out: a <br /> EHD 36-01 5126/05 Page—of— <br />