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SAN JOAQUIN COUNTY <br /> ` E, - . RONMENTAL HEALTH DEPART .NT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ;Fo-• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:wvvw.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: Q City: Zip Code: 3 <br /> Owner/Operator: CZ44hTelephone: <br /> Program Element: Program Record: Inspection Type: /ri,�o <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after. <br /> Other: <br /> E"-T The marked violations represent Health &Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters tVAM, gndiey) a� P G - <br /> ❑ Pumps --�� <br /> ❑ Chlorinato Pot <br /> alv- On OA ig4tL GIK <br /> ❑ Flowmeter rJ k)04- <br /> Gauges <br /> )� ,, l ,,Q s �i W /. �y <br /> ❑ Gauges '��"�"� �Oc. <br /> ❑ Skimmer&Guters 6kAu 3a 0t �-f KP <br /> ❑ Back Flow Prevention Q�Q,trt, <br /> ❑ Main Drain Cover It <br /> ❑ Equalizer Line Cover < <br /> 2 a <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping `110, p, , a l <br /> ❑ Wade Pool-2 Main Drains '6 rN4Lww <br /> ❑ Rescue Pole 3 IQk �.. W <br /> ❑ Life Ring 7 , �FsQi <br /> ❑ Safety Signs 3 C46A �Zx&ffUf <br /> ❑ Lifeguard AKS &1' n ! W <br /> ElPool/Deck Lighting P�e.W.u✓ <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth s/Tiles <br /> El First Aidid Kits Kits <br /> ❑ Emergency Shut-off Switch l� � Qnr� <br /> �.�❑ Showers <br /> ❑ Toilet& Dressing A! , 0� gyp_ 0A <br /> ❑ Ventilation IT"e' <br /> LST "POL k6e7-4 Ar3102o /r'6AUJ EM&AJ 3. C170 <br /> ❑ Chlorine <br /> ❑ pH ilk <br /> ❑ Cyanuric Acid lq 44'eo10 A— � <br /> ❑ Clarityp q � <br /> ❑ Test Kits �3;�Q- <br /> La Q� COrW / j 0x <br /> ❑ Supervision& Control 15.f� ` <br /> ❑ General Sanitation ��Y/"(E /�/ <br /> ❑ Algae <br /> Influe AOA <br /> Time in: Recei Inspe <br /> . v <br /> Effluent: Time Out: <br /> EHD 36-01 7-31-09 SWIMMING POOL OR Page r of_ <br />