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pea.n. SAN JOAQUIN COUNTY <br /> E IRONMENTAL HEALTH DEPAR .NT <br /> � ;`• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 'ko ` * Telephone:(209) 468-3420 Fax:(209) 468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL FFICIAL INSPECTION REPORT <br /> Name of Facility: 0 — Date: <br /> 5 <br /> Address: ( City: t Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: B C Inspection Type: LA <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> /'�� t ' S � Q jr� Other: <br /> REGI CULATION::EQUIPMENT'= The marked violations represent Health&SafetyCode Violations and must be corrected as indicated: <br /> Filters <br /> ❑ Pumps <br /> ❑ Chlorinator <br /> ❑ Flowmeter r <br /> ❑ Gauges <br /> ❑ Skimmer&Guttersfs r <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Coverr I <br /> L <br /> CONSTRUCTION <br /> n <br /> ElPool Shell ...-,.. ___ <br /> ❑ Fencing/Gates v S <br /> ❑ Decking&Coping <br /> ❑ Wade Pool–2 Main Drains 1 0 tl`k� <br /> SAFETYEQUIPMENT r.s <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails <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:30 <br /> (� Time In: <br /> Received By: Inspected by: <br /> Effluent: fl Time Out: 2 <br /> EHD 36-015-88--12 SWIMMING POOL OIR Page of <br />