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SAN JOAQUIN COUNTY <br /> r: ,c <br /> ? <br /> EN ,IRONMENTAL HEALTH DEPARI.ENT <br /> N < <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> .,. P. Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ,GippP� <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: (7 <br /> Address: L3q ity: Zip Code: <br /> Owner/Operator: Telepho :�9 <br /> Program Element: Program Record: Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinslidetiog on or after7 : <br /> Other: <br /> RECIRCULATION EQUIPMENT: The marked violations represent Health&Safety Code Violations and must he corrected as indicated: <br /> ❑ Filters p6P 19 <br /> ❑ Pumps S' <br /> ❑ Chlorinator <br /> ❑ Flowmeter De <br /> A <br /> E] Gauges <br /> ❑ Skimmer&Gutters 'Lt(/ <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> a❑ Pool Shell + <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool—2 Main Drains - 0 <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ LifeguardfA <br /> s <br /> E] Pool/Deck Lighting Ll/j�Q,�(,q,Ij <br /> ❑ LadderstHand Rails <br /> ❑ Depth Markers/Tiles _ <br /> ❑ First Aid Kits QL <br /> A w ' UG <br /> ❑ P.nicn_rnc c Shut-offSwitch <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 <br /> ❑ <br /> Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent <br /> Time In: Receive By: Inspected by: <br /> Effluent: / <br /> Time Out: y 1� <br /> EHD 36-0105-29-2007 Page�,of,� <br />