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PR SAN JOAQUIN COUNTY <br />= EN'VAIDNMENTAL HEALTH DEPARTh. AT <br />`• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />;k6ar Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: W11115 <br />Address: 3 f City: Zip Code: <br />Owner/Operator: ave` Telephone: <br />Program Element: .5(Q(/ Program Record: 03&0&OP Inspection Type::::: 6 a1 <br />Flow Rate (gpm): <br />pH: <br />.. <br />Chlorine (ppm): <br />•U FC <br />Q_a cc_ <br />Cyanuric Acid (ppm): <br />ltSS til <br />317 <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters_ <br />❑ Pumps <br />_ p� �� r <br />�-G�� <br />❑ Chlorinator <br />❑ Flowmeter <br />, <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />- Ir <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 />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />- <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />-- <br />_ <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Timeln: 1 , <br />Received By: <br />" - <br />Inspected by: <br />S, Yh.t <br />Time Out: d <br />EHD 36-01 5-8-12 SWIMMING POOL OIR ` Page — of <br />