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P. n. SAN JOAQUIN COUNTY <br />EN 'ONMENTAL HEALTH DEPARTP VT <br />wi <br />1868 East Hazelton Avenue, Stockton, CA 9521,.,-6232 <br />Telephone. (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REP013 <br />Name of Facility: Date: <br />Address: City: Zip Code: <br />Owner/Operator: <br />Telephone:4/7 <br />Program Element: Program Record: 3 7 Inspection Type: <br />Flow Rate(gpm): <br />a <br />pH: <br />Chlorin6 (ppm): <br />Cyanuric Acid (ppm): <br />D <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EOUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Fillers <br />r9 r <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />2 J <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />ipv <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />h <br />- "CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />v <br />? <br />DI <br />❑ Wade Pool — 2 Main Drains <br />SAFETY EOUIRMENTt' " <br />Rescue Pole <br />_❑ _ <br />❑ Life Ring <br />❑ Safety Signs <br />a j <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />ww <br />❑ Depth Markerslriles <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 />Z <br />Influent: <br />/l I <br />Effluent: I ` /�l' 1 <br />Time In: r- <br />ceived B <br />Inspe ted by: <br />033 <br />Time Out: <br />EHD 3G-015-8-12 SWIMMING POOL OR 1,Page 0f <br />