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SWIMMING POOL OFFICIAL INSPECTION REPORT <br />SAN JOAQ I COUNTY PUBLIC HEALTH SEI CES <br />ENvEAzONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON, CA 95202 <br />(209) 468-3420 <br />BUSINESS ADDRESS <br />-K? <br />Jam <br />STA <br />DATE <br />el—of <br />OWNER'S NAMEIDBA <br />COMPUTER NUMBER <br />3 <br />�^L <br />V�1 d'V�LO(1 <br />�j YCak. <br />Pumps <br />MAILING ADDRESS j I <br />6 <br />7 <br />TIME IN <br />PERMITILIOENSE <br />7 <br />PROGRAMIELEMENT <br />SERE <br />TIME OUT <br />9' <br />10 <br />11 <br />12 <br />C <br />Skimmer & Gutters <br />RATE OPF <br />11 e, <br />r <br />PN <br />foot <br />CL f/� 1 a <br />•O <br />ff5 0 <br />TEMP <br />.) <br />OTHER C_y�VI.L ""C <br />// <br />= i O <br />Waste Water Prevention <br />5 <br />18, <br />M <br />J1 <br />I1 <br />The marked items represent Health Code violations and must be corrects{ as <br />follows: <br />Jam <br />STA <br />OPER <br />Z W <br />Filled <br />2 <br />3 <br />4 <br />a <br />Pumps <br />5 <br />6 <br />7 <br />Chlorinator <br />wFlowmeter <br />7 <br />8 <br />Z <br />0 <br />Gauges <br />9' <br />10 <br />11 <br />12 <br />r <br />J <br />Skimmer & Gutters <br />13 <br />14 <br />Back Flow Prevention <br />15! <br />16 <br />O <br />Waste Water Prevention <br />17. <br />18, <br />Water Supply a Duality <br />UJ <br />¢ <br />Pipe d Fittings <br />19; <br />0zMPool <br />Shell <br />20 <br />21' <br />22 <br />iU <br />Bottom & Sides <br />U¢ <br />Decking & Coping <br />23 <br />24 <br />25 <br />26- <br />Diving Boards <br />Reeure Polo <br />271 <br />28; <br />29 <br />30. <br />Z <br />Life Rings <br />31: <br />32` <br />UJ <br />Safety Signs <br />33 <br />4' <br />Lifeguard <br />0 <br />Lighting Elec. <br />34! <br />35 <br />Ladders <br />36' <br />37 <br />38 <br />39 <br />W <br />U. <br />Depth Marken <br />40: <br />41 - <br />N <br />First Aid Kits <br />42 <br />43 <br />Gas Masks <br />F� <br />Showers <br />44 <br />45 <br />46' <br />47 <br />tu0 <br />Toilet & Dressing <br />¢¢ <br />ventilation <br />48; <br />49. <br />Chlorine <br />50 <br />PH;\..IyI <br />51• <br />Oa <br />Cyanurates • .. <br />52: <br />dQ <br />Clarity <br />53, <br />Test Kits <br />54' <br />¢ <br />Suoervulon a Control <br />55, <br />W <br />X <br />General sanitation <br />56 <br />N <br />O 1 <br />Miscellaneous <br />57, <br />POOL STATUS: (MARK ONE) <br />58 59 60 61 <br />62 <br />E❑ G❑ F❑ P� C❑ <br />�'L(uLYK 30� <br />� <br />-HS u •off'Rr l <br />_ <br />I1 <br />The marked items represent Health Code violations and must be corrects{ as <br />follows: <br />Jam <br />. <br />A ((LeY%�c.^v <br />);1C�V_V'a <br />(11 G - JA.- <br />I C V --A-y' <br />�J l am-✓' i r\ -C Y` L <br />VlI GE.T.L,T <br />akL -Fi knu � ✓ r1.ac�L- "�' <br />G'rrOlf�ti �10/✓ ✓a�t�i � I PvLx.�- <br />onYI I n of 5 S c S <br />fr� <br />N� G4, lam L l 0"(, 'L <br />RI,r~ U'QL <br />eeC_11"e_illU <br />`oS= •crus cke �aos� TTi <br />tL c CL's d I S hn. <br />� (1 5P <br />tv 191—r <br />7--721-01 ' <br />RECEIVED Y: <br />rTwt'NEALTX WSCMI4 <br />PAdV OF <br />1M <br />n\ cN afcw g -/o --0 <br />