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ip <br /> SAN JOAQUIN COUNTY <br /> ENV' )NMENTAL HEALTH DEPARTMi 'T1868 East Hazelton Avenue, Stockton, CA 9520"-,232 <br /> Telephone:(209) 468-3420 Fax:(209) 468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: J fi <br /> Address: City: Zip Code:91 C <br /> Owner/Operator: /0 Telephone: <br /> Program Element: Program Record: e !' .p Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Re inspection on or t3fter: <br /> \ go Other: <br /> 7/ <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&SafetV Code Violations and must be corrected as indicated: <br /> ❑ Filters _ <br /> ❑ Pumps �7 <br /> El Chlorinator /' �T X of <br /> ❑ Flowmeter <br /> Gauges <br /> Skimmer <br /> ❑ Back Flow Prevention / 7/ <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION ' <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates / <br /> Decking&Coping _ <br /> ❑ Wade Pool—2 Main Drains <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> Safety Signs <br /> ❑ Lifeguard <br /> ❑ P oUDeck Lighting <br /> Ladders/Hand Rails <br /> ElDepth Markers/Tile <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS _. <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> WATER QUALITY <br /> ❑ Chlorine <br /> Ll pH <br /> ❑ Cyanuric Acid c� <br /> ❑ Clarity _ <br /> ElTest Kits <br /> MISCELLANEOUS" <br /> ❑ Supervision& control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> l <br /> Influent: <br /> TimeRyuedBy: nspecte by: <br /> Effluent: <br /> Time Out-_-:;T <br /> EHD 3"l 5-8-12 SWIMMING POOL OIAir - ✓ � <br /> A4 Page ot� <br /> G'') <br />