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SAN JOAQUIN COUNTY <br />ENN,RONMENTAL HEALTH DEPARTMrNT <br />Q. <br />304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />9�/PORN <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: City: Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: _ <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑_ Filters <br />- <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />- "_.i 1 --��, � �s •r-z_.Q <br />❑ Pool Shell <br />❑ Fencing/Gates <br />I <br />Decking & Coping <br />e, I.�, <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />- <br />❑ Rescue Pole <br />- <br />❑ Life Ring <br />❑ Safety Signs <br />-- <br />❑ Lifeguard <br />+ /' <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />- <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 />_ <br />General Sanitation <br />Algae <br />Influent: <br />Effluent: �` <br />Timeln: A 0Received <br />By: Inspected by: <br />�� / <br />Time Out: 10 1N1 5 <br />EHD 36-015/26/05 Page _, of <br />