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�I SAN JOAQUIN COUNTY <br /> EN' 'ONMENTAL HEALTH DEPARTI IT <br /> N <br /> 1868 L..at Hazelton Avenue, Stockton, CA 9526 -6232 <br /> 0'Y <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: <br /> Address: 2y Q r n. !S--V City: zip Code: q 33 <br /> Owner/Operator: Telephone: b 9� – 29.'19 <br /> Program Element: 1 rogram Record: W4- Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> C 2-.,,A G ?'� Other: <br /> C . C © `-1 �l <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps <br /> ❑ Chlorinator <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ . Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains <br /> SAFETY. EQU(FMENT ' -, <br /> ❑_ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/files <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 2 -vy-� - � .� Is <br /> ❑ Clarity <br /> ❑ Test Kits <br /> ❑ Supervision&Control l� <br /> ❑ General Sanitation <br /> ❑ Algae 1 <br /> Influent: ?)0 . <br /> Time In: C.i : So Re eiv Inspected by: <br /> K. L;nVNokfes <br /> Effluent: Tlme0ut: ,0 'A `1 b 16-O '.-o <br /> EHD 36-015-8-12 SWIMMING POOL OIR Page—of <br />