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Pp U,�N SAN JOAQUIN COUNTY <br /> e°'"_,�"coo <br /> r `~"� Er1 VIRONMENTAL HEALTH DEPARTMENT <br /> a: Z <br /> 304 East Weber Avenue, 3 d Floor, Stockton, CA 95202-2708 <br /> �., P Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjgov.org/ehd <br /> 4tIFORN <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: Ch: &-i Zip Code: <br /> Owner/Operator: Telephone: ,2 <br /> Program Element: 3 Program Record p V/ y Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after. <br /> RD Other: <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 -k o(A- JVVI ^' —11-049 <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 /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers(riles <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 <br /> ❑ Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: ,,,yyy1A 17 <br /> Time In: ..D Rec a Inspected by: / <br /> Effluent: // q"-. el .(- <br /> TimcOnt: <br /> EHD 36-01 5/26/05 Page I of <br />