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�I„.. SAN JOAQUIN COUNTY <br />ENb1RONMENTAL HEALTH DEPARTivn�NT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />4 <br />Date: <br />Address: <br />city: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: <br />Program Record: <br />Inspection Type: <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp:'Reinspection <br />on or after: <br />Other: <br />-RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety <br />Code Violations and must be corrected as indicated: <br />El Filters <br />r v�— <br />41444 <br />a'p <br />410k, le.Y).rAk/ <br />❑ Pumps <br />a <br />❑ Chlorinator <br />❑ Flowmeteryy <br />A„ „ <br />El Gauges <br />f <br />` <br />ee <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />V <br />_ <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />.CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <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 MarkersTriles <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 />t <br />72� <br />MISCELLANEOUS - <br />❑ Supervision & Control <br />I <br />❑ General Sanitation <br />❑ Algae <br />J) <br />✓{.� <br />Influent: <br />Effluent:Time <br />0-� <br />Time In: <br />Race'v it <br />nape ted by: <br />(> <br />Out: <br />EHD 38-01 5-8-12 SWIMMING POOL OIR Page -L of A <br />