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ip <br /> SAN JOAQUIN COUNTY <br /> ENVIKONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: - f} 'G Date: p'/- <br /> Address: �.S city: Zip Code: 9C 3 <br /> Owner/Operator: , �. Telephon :A / <br /> Program Element: 3C-. Program Record: N 3� 0C27 Inspection Type: eou:4 <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> � •� �c = 3, a <br /> CC TH�ioY®Da' Other: <br /> F"IljM The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps <br /> ❑ Chlorinator AbNL C o D 2 rt h�G/) <br /> ❑ Flowmeter <br /> ❑ Gauges 5OW 5 ant / oV r <br /> El Skimmer&Gutters U C� (^ be- cj C17 eC-� S/s <br /> ❑ Back Flow Prevention r, <br /> El Main Drain Cover -c o wt 49 S 40C (72 <br /> ❑ Equalizer Line Cover <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains I�OWI evl <br /> a , - s N = FC = a. cc = 8 <br /> ❑ Rescue Pole nn <br /> ❑ Life Ring o/°F -p:% laeu, -fFF <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 /> S <br /> ❑ Showers <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation LYl Gt 36�� P1236o�25 <br /> FR FC= 4. 6 _ pPOVl <br /> ❑ Chlorine <br /> ❑ pH M 0 � <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: 2,7, psi <br /> Time In:d ;3o/1/r'I Received By: Insp cted by: <br /> Effluent: ) �Xq Q5( <br /> I !i I Time Out: <br /> EHD 36-017-31-09 SWIMMING POOL OIR Page-4-of— <br />