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SAN JOAQUIN COUNTY Y. ENxj )NMENTAL HEALTH DEPARTM. T 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd SWIMMING POOL OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: ; L City: Zip Code: Owner/Operator: Telephone: Program Element:�(J Program Record: i� p Inspection Type. Flow Rate (gpm): pH: 7<0 f 7 Chlorine (ppm): Q •� C anuric cd pm): r'rcc�2c� N too Temp: Reinspection on or after : Other: RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must be corrected as indicated: ❑ Filters -- El Pumps c� Yh Q l�y�A avt Q/wa"(i )04 ❑ Chlorinator ❑ Flowmeter /261 El Gauges I �} I t �Ill' 7 -19 yj�yl A ❑ Skimmer & Gutters ❑ Back Flow Prevention 1VV�# 1112 D" RSV G(,(N4 ❑ Main Drain Cover /f C mak&,- �qvt !OD & matte d� ❑ Equalizer Line Cover CONSTRUCTIONFev - wk P eALAL `� m ✓ Ul Vwfd E] Pool Shell ❑ Fencing/Gates PP ��rl a ✓H X 3 D'r ❑ Decking & Coping 011 don I t (a oal �tvwt- qiloof ❑ Wade Pool - 2 Main Drains SAFETY EQUIPMENT �/f N -- e� -� u ❑ Rescue Pole ❑ Life Ring ❑ Safety Signs ❑ Lifeguard %(%w G( ✓ a } — 0p ❑ PooVDeck Lighting ❑ Ladders/Hand Rails (J '� [:]Depth Markersf iles ❑ First Aid Kits ❑ Emergency Shut-off Switch RESTROOMS ❑ Showers ❑ Toilet & Dressing ❑ Ventilation WATERQUALITY' ❑ Chlorine 014 ❑ pH ❑ Cyanuric Acid , r kni "e ❑ Clarity ❑ Test Kits MISCELLANEOUS. ❑ Supervision & Control ry y I �" n O� �(( rl/Wl �/vl , w T/ E] General Sanitation ❑ Algae n,a/L Influent: ti� Effluent: p to Time In: Race' a Inspected by: 1/,. Time Out: 14Y EHD 36-01 5-6-12 SWIMMING POOL OIR Page — of