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S <br />P <br />ip <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMEiv i1868 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: Date: (D- I —13 <br />Address: Gj C City:Ck\Of Zip Code: 9 's 25 <br />Owner/Operator: Telephone: <br />Program Element:.3 ` (p 'ZProgram Record: -6,0 S 5tnInspection Type: <br />Flow R m): <br />p : <br />.� <br />Chlorine ppm): <br />5. cc O. <br />Cyanuric Aci�.{ppm): <br />7 (\}v. <br />Temp: I Q I <br />Reinspection on or after: <br />�0 <br />-:I-.b <br />Fc 3 i cc00 <br />-::to <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />C <br />`J <br />_ <br />❑ Pumps <br />❑ Chlorinator <br />t G 1 ( 7 <br />❑ Flowmeter <br />C <br />❑ Gauges Q <br />❑ Skimmer & Gutters s <br />❑ Back Flow Prevention -eLtN' <br />❑ Main Drain Cover <br />2 \ ' <br />❑ Equalizer Line Cover <br />- CONSTRUCTION .- <br />❑ Pool Shell <br />?) <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />\ <br />❑ Wade Pool -2 Main Drains <br />SAFETY EQUIPMENT <br />❑ Rescue Pole <br />^� <br />❑ Life Ring <br />❑ Safety Signs <br />\` <br />[3Lifeguard <br />b <br />❑ Pool/Deck Lighting 5 <br />❑ Ladders/Hand Rails <br />❑ Depth Markersfnles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />—Q S <br />--1'"'RESTROOMS:'s <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />Z <br />WATER QUALITY <br />❑ Chlorine <br />3 <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />_ <br />- <br />❑ General Sanitation <br />❑ Algae <br />spm u-�e <br />Influent: , C 1 5 <br />J <br />Time In: yO <br />Re ve <br />yz <br />Inspected by: <br />V L� <br />Effluent: `u <br />Time Out: ` 1'S <br />EHD 36-01 5-8-12 SWIMMING POOL OIR <br />4 b� O33 O Page 1 of <br />