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SWIMMINV POOL OFFICIAL INSPECTION REo JRT <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICE <br />ENVIRONMENTAL HEALTH DIVISION <br />POST OFFICE BOX 388, STOCKTON CA 95201 <br />BUSINESS ADDRESS <br />I IC S26 6W <br />4VLAt,' 'M- <br />STR <br />DATE <br />Ibl qV <br />OWNER'S NAMEIDBA <br />*IPAJ, <br />/ <br />Irlr� <br />2 <br />COMPU RNUMBER <br />MAILING ADDRESS <br />3 <br />4 <br />TIME IN <br />eVk%iWr (ATO -so - <br />85� <br />PERMITILICENSE <br />Lu <br />Flowmeter <br />PROGRAMIELEMENT <br />SERVICE <br />TIME OUT <br />Gauges <br />9 <br />10 <br />Skimmer 8 Gutters <br />11 <br />RATE OF FLOW <br />PH <br />CL I ^ <br />. `Y gym <br />TEMP <br />OTHER /'�,• 1, (�-, ��u <br />"`' r.�"`bW:1V e4it. <br />H <br />STR <br />OPER <br />Z <br />Fillers <br />1 <br />2 <br />U.' <br />a <br />Pumps <br />3 <br />4 <br />5, <br />6 <br />Chlndnalor <br />Lu <br />Flowmeter <br />7 <br />8 <br />Z <br />Gauges <br />9 <br />10 <br />Skimmer 8 Gutters <br />11 <br />12 <br />Back Flow Prevention <br />13 <br />114 <br />2 <br />Waste Water Prevention <br />15 <br />16 <br />17 <br />18, <br />Water Supply d Gustily <br />U.1 <br />Cr <br />Pipe 8 Fillings <br />19, <br />O <br />Pool Shell <br />YA <br />20 <br />21 <br />22 <br />Zl- <br />Bottom & Sides <br />00¢ <br />Decking 6 Coping <br />23 <br />24 <br />1—Diving <br />Boards <br />25 <br />26, <br />Rasura Pole <br />27. <br />28 <br />Z <br />Life Rings <br />29! <br />30, <br />31 <br />32` <br />Safety Signs <br />33 <br />o' <br />Lifeguard <br />Lighting Else. <br />34� <br />35 <br />LU <br />Ladders <br />36: <br />37 <br />38 <br />39' <br />LL <br />Depth Markers <br />40 <br />41 <br />N <br />First Aid Kits <br />42, <br />43 <br />Gee Masks <br />�U) <br />Showers <br />4445 <br />46' <br />47 <br />WO <br />Toilet d Dressing <br />¢¢ <br />Ventilation <br />46; <br />49. <br />Chlorine <br />50 <br />pH <br />51 <br />OO< <br />Cyanurates <br />52: <br />a7O <br />Clarity <br />53, <br />Teel Kilo <br />54! <br />¢ <br />Supervision a Control <br />wx <br />General Sanitation <br />r5' <br />61- <br />O <br />Miscellaneous <br />7 <br />POOL STATUS: (MARK ONE) <br />56 59 60 61 <br />62 <br />E❑ G[] F❑ P❑ C❑ <br />PHS -EH 182 (6R6) <br />rl <br />The marked items represent Health Code violations and must be correcte as <br />follows: <br />W <br />OFFICE ADDRESS <br />304 EAST WEBER AVENUE, STOCKTON CA <br />(NO MAIL IS RECEIVED AT THIS ADDRESST <br />TELEPHONE (209)4883420 <br />OF <br />