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OPgUIN SAN JOAQUIN COUNTY <br />c` ENVIRONMENTAL HEALTH DEPARTMrNT <br />2: y <br />600 East Main Street, Stockton, CA 95202-3029 <br />..p.. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.s4Qv.org/ehd <br />9<I FOPS <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: - - - Date: D <br />Address: I city: Zip Code: 9 -7 <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters _ <br />❑ Pumps <br />m H <br />Aokl` dAanell <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />c q <br />❑ Main Drain Cover <br />' <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />❑ Pool Shell <br />, l(V <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />- - <br />❑ Wade Pool — 2 Main Drains <br />SAFETY EQUIPMENT <br />� , u + dA � �`a � /l <br />butt, <br />`c(A W <br />❑ Rescue Pole <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />! _ cSM A tt <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />A /f� <br />❑ Depth Markers/riles <br />❑ First Aid Kits <br />❑ Emergency Shut-off switch <br />- RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />n dla4l- <br />r <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: <br />Effluent: <br />todic A -p Ge71' suK, Siva /yY.t'�f Tc ca./o , <br />Time In: <br />Time Out: <br />Recel e B <br />Inspectedby; <br />V/e CJ t <br />EHD 36-017-18-08 SWIMMING POOL OR <br />