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I SAN,JOAQUIN COUNTY <br /> c <br /> N EN ,.AONMENTAL HEALTH DEPART T j <br /> 304 East Weber Avenue, 3 d Floor, Stockton, CA 95202-2708 1 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjgov.org/ehd <br /> 4C�FOPa <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: T„ Date: <br /> Address: Q W `'Ke n City: �tzxi Zip Code: <br /> Owner/Operator: Telephone: —4-(,6. lSi <br /> Program Element: (pV Program Record: —7_7 Inspection Type: <br /> Flow Rate(gpm): -7pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> 7 Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters Gy-aj6f,It JAS TIA tSSI w. 4,W0t <br /> ❑ Pumps <br /> ❑ Chlorinator I S 1� 4fi +41K <br /> 1K <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> ,CONSTRUCTION D!>• _ L i5 D�� l `-�`( <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates U ' <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 <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <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 <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent <br /> Time In: a' R ceived By: Inspected by: <br /> Effluent <br /> Time Out: �V <br /> EHD 36-015/26/05 Page_of_ <br />