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ip <br /> SAN JOAQUIN COUNTY <br /> EN..RONMENTAL HEALTH DEPARTi�._NT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> SWIMM NG POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: 9/63/1/ <br /> Address: 0 City: WaAAaZip Code: 3 <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type:A4)102_6 <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 <br /> ❑ Pumps <br /> ❑ Chlorinator <br /> ❑ Flowmeter <br /> ❑ Gauges [/ <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention i _ O <br /> El Main Drain Cover - <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell n <br /> ❑ Fencing/Gates ULt L Cf� <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2-MainDrains <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 /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> --:- WATER QUALITY <br /> ❑ Chlorine <br /> ® a pm wr Fs!^ h -- <br /> El Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits _ <br /> MISCELLANEOUS <br /> ❑ <br /> Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: <br /> Time In: Received By I spetp ed by: <br /> Effluent: <br /> Time Out: �d�3 <br /> EHD 36-017-31-09 SWIMMING POOL OR Page of I <br />