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ip <br />SAN .JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM—IVT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Teephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />RWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />rnVx(/1 <br />Date: <br />Address: -- <br />tr City: Zip Code: <br />Owner/Operator: W,'V/'VLA Telephone: � `p <br />Program Element: i <br />Program Record: O Inspection Type: VL - <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspecti n on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & SafeCode Violations and must be corrected as indicated: <br />❑ <br />Filters <br />❑ <br />Pumps <br />c / <br />J L [ / L WI �T — C r! (i(/`L e I'1 <br />❑ Chlorinator <br />❑ <br />Flowmeter <br />I -,VIPK'lY� _ <br />[I <br />Gauges <br />jv <br />❑ Skimmer & Gutters <br />❑ <br />Back Flow Prevention <br />/ <br />Ul �! <br />❑ <br />Main Drain Cover <br />[J (/%1 I �l <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />❑ <br />Pool Shell <br />j <br />77 i 1/7 <br />Vi <br />❑ Fencing/Gates <br />❑ <br />Decking & Coping <br />❑ <br />Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />❑ <br />Rescue Pole <br />Al <br />Z l_ / 41A ti V7 <br />❑ Life Ring <br />❑ <br />Safety Signs <br />[N all - <br />Lifeguard❑ <br />Pool/Deck Lighting <br />❑ <br />Ladders/Hand Rails <br />❑ <br />Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ <br />Emergency Shut-off Switch <br />RESTROOMS <br />- <br />❑ Showers <br />❑ <br />Toilet & Dressing <br />❑ <br />Ventilation <br />WATER QUALITY <br />❑ <br />Chlorine <br />-- <br />❑ <br />pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ <br />Test Kits <br />MISCELLANEOUS <br />❑ <br />Supervision & Control <br />❑ General Sanitation <br />❑ <br />Algae <br />Influent: <br />Effluent: <br />Time ln: <br />einv'ed By: <br />,Ri-t!! <br />inspected by: <br />lq Y}'I[ k -.e- ` <br />Time Out: - <br />EHD 36-01 5-8-12 SWIMMING POOL OR Page — of <br />