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aur. SAN JOAQUIN COUNTY <br />E RONMENTAL HEALTH DEPAR' :NT <br />µ �) 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 />Date: <br />Address: 5 ( P <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />G 2 — 'Zy� <br />Program Element: 1 I 12,j.12 ProgramRecord: <br />Inspection Type: <br />— <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspettion on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ FiltersP <br />Sloo <br />❑ Pumps <br />O. I, S 1 — I <br />❑ Chlorinator <br />❑ Flowmeter <br />1L� 1F( � <br />El <br />, <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover- <br />f e - <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />❑ Pool Shell <br />_ <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />(��,, ^ p n 2 <br />\ 1 `OZ - �.. -L- ` I` J 0 1 <br />IS 3 2Z <br />SAFETY EQUIPMENT <br />t <br />—19_ I — t� _ _ <br />I `- <br />e1_ <br />Y �. <br />—IRescuePole <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />1A <br />R <br />❑ PooVDeck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />© <br />_ <br />Q - aZe <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />3 <br />C 'S 3 ZZ <br />❑ Ventilation <br />WATER ,QUALITY <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS{�— <br />-) <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent:- <br />Time In: 1 r- R ceived <br />--- <br />Time Out: 2 <br />Inspected by: <br />�- <br />_ 3 <br />EHD36-015-8-12 SWIMMING POOL OIR ` S�tM `�'t-f/V �M(� (( Dr1 Page h of <br />