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Pqp'" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> • r.., - . ;P.� Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> 4�/FORS <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ( ,�C'v y� Date: cb M <br /> 40- <br /> Address: SA V4 Ag- City: ` Zip Code: <br /> Owner/Operator: j Telephone: q,^ 746 <br /> Program Element: Program Record: Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or afte7 r: <br /> Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps Nn�S <br /> ❑ Chlorinator •(7,t,e� I'+'� <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates d l3 <br /> ❑ Decking&Coping t <br /> ❑ Wade Pool-2 Main Drains <br /> SAFETY EQUIPMENT 1 Q� _ <br /> El Rescue Pole rl <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard VV 11 <br /> ❑ Pool/Deck Lighting F-- XLb <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: <br /> Time In: Received By: Inspected by: <br /> Effluent t4 � <br /> "Time Out: rA.N 6• <br /> EHD 36-01 5/26/05 Page_of <br />