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Q S aPa�.ln. SAN JOAQUIN COUNTY ` ENVIRONMENTAL HEALTH DEPARTMENT '• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd SWIMMING POOL OFFICIAL INSPECTION REPORT Name of Facility: d Date: -1 - I — , Address: kq Q SZ City:- Zip Code: C( Z Owner/Operator: r0 Telephone: Program Element: Sloe 31012 Program Record: 3 S 3 Inspection Type: Flow Rate (�pm): v pH: G. Q Chlorine (ppm): o.2 k. t0 yanuric Acid (ppm): S Temp: 1 �1 1= Reinspection on or after. other: RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must be corrected as indicated: ❑ Filters S ❑ Pumps ` '1 1 e ❑ Chlorinator ❑ Flowmeter ❑ Gauges Q C 1 j ❑ Skimmer & Gutters ❑ Back Flow Prevention n `Y �" C I ❑ Main Drain Cover ej QA 0"-A \ , 'S 5 ❑ Equalizer Line Cover CONSTRUCTION C Q ` t ❑ Pool Shell ❑ Fencing/Gates n ❑ Decking & Coping 3 C t Cn �C to ❑ Wade Pool - 2 Main Drains SAFETY EQUIPMENT v ❑ Rescue Pole C 1 W\ �fS ❑ Life Ring ❑ Safety Signs 3 TVIP ❑ Lifeguard p ❑ Pool/Deck Lighting ❑ Ladders/Hand Rails �C ❑ Depth Markers/Tiles n ❑ First Aid Kits ❑ Emergency Shut-off Switch I RESTROOMS �e.re.Q ❑ Showers\ El Toilet & Dressing ©.2 - /t r^ ,e "4j % - El Ventilation �, — 1�, 0 no 1 `,%'3'ACAA WATER QUALITY ❑ Chlorine El T e r I I— ,Q ❑ Cyanuric Acid ,Q ❑ Clarity ❑ Test Kits MISCELLANEOUS ❑ Supervision & Control C III,. I W� ❑ General Sanitation ❑ Algae S SITSq Influent: � � 1 v C ` ` 1 Effluent:� � 6&k t • Time In: 1�1 Receiv � Inspected by: � , Ln ae\ ► \A/ Time Out: \ iLS EHD 36-015-8-12 SWIMMING POOL OIR rj ti5!�2d +>..,, 1& �' -j –' Page — of e L)