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P4 '" SAN JOAQUIN COUNTY <br />?a EN v IRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Far: (209) 464-0138 Web: www.sjgov.org(ehd <br />9 <IFOr� <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date:3 <br />Address: <br />City:f-�, Zip Code: <br />Owne00perator: Telephone: <br />Program Element: Prog m Record: Y Inspection Type• <br />Flow Rate (gpm):pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <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 />❑ <br />Filters <br />v� "+�'t!/� <br />0 0 ff 116613 <br />Pumps <br />rn ` <br />❑ Chlorinator <br />❑ <br />Flowmeter <br />❑ <br />Gauges <br />❑ Skimmer & Gutters <br />❑ <br />Back Flow Prevention <br />-� Q <br />❑ <br />Main Drain Cover <br />✓ _ �jC.Q/`(P� �/.L(i(, LiGZ,^-YJ� <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />• <br />❑ Pool Shell <br />❑ <br />Fencing/Gates <br />,V ' �Ttit <br />❑ <br />Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />❑ <br />Rescue Pole <br />r C <br />❑ Life Ring <br />❑ <br />Safety Signs <br />c <br />❑ <br />Lifeguard <br />�/�(/(lLd=- A4- P94 <br />E] Pool/DeckLighting <br />❑ <br />Ladders/Hand Rails <br />a• <br />❑ <br />Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ <br />Emergency Shut-off Switch <br />r�^-I�MiT'• <br />RESTROOMS-�'� <br />/,/"'r�"r-/"u1l�Cw/yo _ <br />�"�!r'tvTh�lY , M1�C✓�� <br />❑ Showers <br />❑ <br />Toilet & Dressing <br />❑ <br />Ventilation <br />WATER QUALITY <br />❑ <br />Chlorine <br />❑ PH <br />❑ <br />Cyanuric Acid <br />6 <br />❑ <br />Clarity <br />N� by n ` <br />Zv ` ` � "^-' ' `5v ` At7 z <br />❑ Test Kits <br />MISCELLANEOUS <br />Z <br />❑ <br />Supervision & Control <br />Qhei <br />❑ General Sanitation <br />❑ <br />Algae <br />,` t <br />Influent: t.. <br />Effluent: <br />Time In: <br />Received By: <br />`� <br />Inspected by: <br />Time Out: <br />EHD 36-0105-29-2007 Page r of L <br />