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pe1N SAN JOAQUIN COUNTY <br />ENv,i2ONMENTAL HEALTH DEPARTN.—AT <br />600 East Main Street, Stockton, CA 95202-3029 <br />.. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />9r/FORS <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: r Date: b <br />Address: isCity: r Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: iuc <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm):Cyanuric <br />Acid (ppm): <br />Temp: <br />fReinspection on or after: <br />Other: <br />-7 <br />RECIRCULATION EQUIPMENT <br />The marked violations re resent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />❑ Chlorinatorn <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />ir <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />IF <br />d <br />❑ Wade Pool — 2 Main Drains <br />SAFETY EQUIPMENT <br />❑ Rescue Pole <br />❑ Life Ring <br />❑ Safety Signs <br />ly <br />❑ Lifeguard <br />/1)" '14 <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />V I tfQ R <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />,r <br />r <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />_ <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Time In: j O <br />Ir <br />Time Out: `� <br />Received By: Inspected by: <br />/ /� <br />l-1 G" �' J�/ <br />EHO 36-017-18-08 SWIMMING POOL OIR <br />