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ail.' <br /> 5AN JOAQUIN 6OUNTY <br /> ?.;9 ,. <br /> ENV -)NMENTAL HEALTH DEPARTM`7 <br /> \.: 1868 Ear, Hazelton Avenue, Stockton, CA 9520:. .,232 <br /> —�o Telephone: (209) 468-3420 Fax: (209)468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0-0 Date: <br /> Address: Ale Rd City: e1C -A Zip Code: A5�2 pe( <br /> Owner/Operator: Kb 9:� 413 Telephone: �UT — ?y <br /> Program Element:361 J G1,2Program Record:Qs 3c)3 /06-14J 3 04 Inspection Type: Foyle-blKA-0 <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid Temp: Other: Reinspection on or after: <br /> 100c rm P 9'0 P 1 .S epm p _ <br /> ? s d 5 n, � m) <br /> L3°Z-30 3 9 ry ©r <br /> MAJ=Major Violation OUT=Not in Compliance COS=Corrected on-site <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. Items listed on this report as violations do not <br /> meet the requirements set forth in the California Health and Safety Code section(s)116043, 116040,&116050. All violations must be corrected within <br /> specified timeframe. Violations that are classed as"MAJOR"pose an immediate threat to public health and must be corrected immediately orbe subject to <br /> closure pursuant to California Code of Regulations(Title 22)section 65545. <br /> VIOLATION MAJ OUT COS VIOLATION MAJ OUT COS <br /> 1 Pool Gates ❑ ❑ ❑ 35 Flow Meters 19 ❑ <br /> 2 Pool Enclosure ❑ ❑ ❑ 36 Pressure and Vacuum Gauges ❑ ❑ <br /> 3 Safety Signs ❑ ❑ 37 Electrical Hazards ❑ ❑ ❑ <br /> 4 Safety Equipment ❑ ❑ ❑ 38 Filter Cleaning and Maintenance ❑ ❑ <br /> 5 Restrooms and Showers ❑ ❑ 39 Wastewater Disposal ❑ ❑ <br /> 6 Hose Bibb Anti Siphon Device ❑ ❑ 40 Spray Ground UV Disinfection ❑ ❑ ❑ <br /> 7 Pool Deck ❑ ❑ 41 Spray Ground Pumps Interconnected ❑ ❑ ❑ <br /> 8 Pool Deck and Lighting ❑ ❑ 42 Spray Ground Recirculation System ❑ ❑ ❑ <br /> 9 Ladders and Handrails ❑ ❑ 43 EHD Approval Required ❑ ❑ ❑ <br /> 10 Disinfectant Residual ❑ im 44 Lifeguard Certification ❑ ❑ <br /> 11 Combined Chlorine Concentration ❑ ❑ 45 Lifeguard First Aid Equipment ❑ ❑ <br /> 12 pH Level ❑ JL 999 Other ❑ ❑ ❑ <br /> 13 Cyanuric Acid Concentration ❑ ❑ ❑ <br /> 14 Chemical Water Test Kit ❑ ❑ 1 <br /> 15 operation Records ❑ ❑ bAlep" r) _) D <br /> 16 Water Clarity El El ❑ <br /> 17 Cleanliness of Pool ❑ E] f <br /> 18 Pool Shell and Tile ❑ ❑ 2. #9 to%1 .ft!61 f e'-, 'Id� <br /> 19 Depth Markers El El ar <br /> 20 Depth Marking Line ❑ ❑ UJ 9 <br /> 21 Water Level ❑ ❑ %otoga-)c ( (' ;55i' or <br /> 22 Skimmer Assembly TK ❑ 66� Vi_t <br /> 23 Pool Inlets and Outlets El ❑ GL _ PP�� <br /> 24 VGB Suction Covers El El ❑ oW + Ki .1cor <br /> 25 Spa Emergency Shut Off Switch F-1 ❑ ❑ D <br /> 26 Spa Operating Temperature ❑ ❑ ❑ <br /> 27 Pool Equipment Room ❑ ❑ <br /> 28 Safety Vacuum Release System ❑ ❑ ❑ : <br /> 29 Recirculation System Operation ❑ ❑ ❑ <br /> 30 Pool Equipment&Plumbing Maintained EJ ❑ C 0 <br /> 31 Disinfectant Feeders ❑ ❑ ❑ <br /> 32 Chemical Control and Monitoring System ❑ ❑ -f . k ti lo 10 <br /> 33 Minimum Turnover Time ❑ ❑ <br /> 34 Maximum Flow Rate ❑ ❑ <br /> ALL EHD STAFF TIME ASSOCIATED WITH BRIN THIS FACILITY INTO COMPLIANCE,INCLUDING REINSPECTIONS,WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> Time In: Time Out: Rece' e Inspec ed; <br /> EHD 36-01 Rev.68/08/16 '/QQ� VC P-kd • 0)vt Page 1 of SWIMMING POOL OIR <br />