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a�Iq. SAN JOAQUIN COUNTY <br /> Er,' IONMENTAL HEALTH DEPART' NT <br /> 1868 East Hazelton Avenue, Stockton, CA 952 ,,-6232 <br /> q6=Ha Telephone:(209) 468-3420 Fax:(209) 468-3877 Web:www.sjgov.org/ehd D� <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: � Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: elephone: g <br /> Program Element: Alf Program Record: V 360 56Inspec' n Type: <br /> Flow Rate(gpm): p hl <br /> (Rda 013odE a(p m): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> , �G <br /> � I` O' O G Omer: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters r <br /> ❑ Pumps <br /> ❑ Chlorinator Z <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> 2 rut G daJacv <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover ��J A. t" • 6ftigicZ Z r <br /> ❑ Equalizer Line Cover <br /> . . :.' _CONSTRUCTION 3 <br /> ❑' Pool Shell �fiP� Ci <br /> ❑ Fencing Gates Ll 712-4113. <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains <br /> SAFETY EQUIPMENT J <br /> ❑ Rescue Pole <br /> ❑ Life Ring _ <br /> ❑ Safety Signs _ <br /> ❑ Lifeguard I If <br /> ❑ POOUDeck Lighting <br /> ❑ Ladders/Hand Rails o <br /> ❑ Depth Markers/Tiles <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 /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: "1� ^�`I �•c <br /> Qr y4✓ Time In:/ ; 56 Rec ived B 1 sp ted by: <br /> Effluent: 7 '�L I Time Out: <br /> EHD 36-015-8-12 SWIMMING POOL OIR Page-4-a-1— <br />