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P.uln. SAN JOAQUIN COUNTY <br /> EN\ 3NMENTAL HEALTH DEPARTN. J <br /> 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: d.� Date: �( <br /> Address: T72 r YV r LLIfcity: Zip Code: <br /> Owner/Operator: Y1Gc' Telephone: <br /> Program Element: Program Record: r' j "S --7 Inspection Type: /2Z(, / <br /> Flow Rate (gpm): pH: Chlorine(ppm Cyapunp/jcjcj(�m): Temp: Reinspection on or after: <br /> 7 , Le G ✓CY C(/U(i <br /> Other: <br /> t� C Cyan <br /> RECIRCULATION:EQUIPMENT The marked Violations represent Health&Safe Code Violations and must be corrected as indicated: <br /> ❑ Filters q ,1 <br /> ❑ Pumps I <br /> ❑ Chlorinator 14 ( h <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters J <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates I ' R dilVI <br /> ❑ Decking&Coping `� <br /> ❑ Wade Pool-2 Main Drains l� J� <br /> SAFETY EQUIPMENT - m J` Y <br /> ❑ Rescue Pole _ <br /> ❑ Life Ring r <br /> ❑ Safety Signs <br /> ❑ Lifeguard r <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 /> [3 Algae <br /> /�� n/ )oa 4vy/ tC/ft�rwt Vl 1G� <br /> Influent: I Y r llIV �i ki /l �'V fi/ U� v II <br /> Simeln: �? Received By: Inspected by: <br /> Effluent: <br /> Time Out: I <br /> EHD 36-015-8-12 SWIMMING POOL OIR Page_of_ <br />