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pp U N SAN JOAQUIN COUNTY z ENVIRONMENTAL HEALTH DEPARA ENT 600 East Main Street, Stockton, CA 95202-3029 r. �P • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 9�FOR� SWIMMING POOL OFFICIAL INSPECTION REPORT Name of Facility: Date: : ''31 Address:had City: Zip Code: Owner/Operator:Telephone: Program Element: Frog m Record: Inspection Type• Flow Rate (gpm): pH: Chlorine (ppm): Cyanuric Acid (ppm): Temp: Reinspection on or after: Other: RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must be corrected as indicated: ❑ Filters & Gt'6LOL- ?O(' _ O ,66 ElPumps /1°IA44- ❑ Chlorinator ❑ Flowmeter O/J• ® _ sG'Le U 3 * t,;, 644 ❑ Gauges ❑ Skimmer & Gutters ❑ Back Flow Prevention Q �' E] Main Drain Cover ❑ Equalizer Line Cover ✓ _ lj A/x A CONSTRUCTION < V ❑ Pool Shell ❑ Fencing/Gates _ , r ' ❑ Decking & Coping ❑ Wade Pool — 2 Main Drains SAFETY EQUIPMENT ❑ Rescue Pole r _ ❑ Life Ring ❑ Safety Signs ` -V�A-' ❑ Lifeguard --�._ .y�- //C�21�1/f'�t. � J Wim' ..i/i/l�Lv4.(�e-r� A_ &L44.. G 04 ❑ PooVDeck Lighting ❑ Ladders/Hand Rails 1.•C�"l^ ❑ Depth Markers/Tiles ❑ First Aid Kits ❑ Emergency Shut-off Switch RESTROOMS ❑ Showers ❑ Toilet & Dressing ❑ Ventilation WATER QUALITY ❑ Chlorine ❑ pH ❑ Cyanuric Acid ❑ Clarity 4A, 04 416 ❑ Test Kid C Uh4MS i m 2 •rvisiorrA ontrol I .Fid _ ❑` 4GepefaMSanitation 1:344lgae Influent: Effluent: Time In: Received By: � �_ �- IInnspectteedd ,by: ✓ ��`^'^' u`` Time Out: EHD 36-0105-29-2007 / Page ( of L