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SAN JOAQUIN COUNTY <br />N < <br />Ery IONMENTAL HEALTH DEPARTI VT <br />:I <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 �" <br />Telephone: (209) 468-3420 Fak: (209) 468-3877 Web: www.sjgov.org/ehd of/d <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />0`­a4taV *,%,,qt <br />Name of Facility: Date:11(e I / <br />Address: City: Zip Code: -7 1JC <br />Owner/Operator: - OJ <br />elephone: d <br />Program Element: Program Record: Inspection Type: <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Rein pection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ FilterAj <br />s <br />A8;020 1(6 8 <br />❑ Pumpsg <br />n w ' <br />❑ Chlorinator <br />❑ Flowmeter♦ <br />/1 <br />'et Lf <br />E] Gauges <br />,fit,, { (�tA <br />E] Skimmer & Gutters <br />❑ Back Flow Prevention <br />W 4 <br />lz <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />& <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping�t' <br />� V 0 144—Q <br />E] Wade Pool — 2 Main Drains <br />SAFETY. EQUIPMENT ':I - <br />❑ Rescue Pole <br />or Y C $L 4 <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />yaw ON <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />RESTROOMS <br />i <br />Q <br />❑ Showers <br />❑ Toilet & Dressing <br />g A. <br />� Ajj4 <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />r n <br />�(cCIQ <br />2gatZd i <br />❑ pH <br />❑ Cyanuric Acid <br />t <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS' <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Time In; (� <br />Recej}'ved. .6 y: <br />1 Ct,-�'-e L <br />___A.. __ <br />I spec ed by: <br />61/� <br />TimeOut:( <br />EHD 36-01 5-8-12 SWIMMING POOL OIR <br />Page _�_ILL <br />