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SWIM IG POOL OFFICIAL INSPECTI PORT <br />SAN J%,S+QUIN COUNTY PUBLIC HEALT PORT <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 2009, STOCKTON, CA 95201 <br />BUSINESS ADDRESS <br />ZE?U. <br />STR <br />OPER <br />DATE <br />liar 6e, <br />1Z <br />Z <br />12 3L9 <br />OWNER'S NAMEIDBA <br />2 <br />a <br />Pumps <br />COMPUTER NUMBER <br />(aa <br />1vtr,\ <br />Ex press <br />5, <br />6. <br />MAILING ADDRESS <br />Chlorinator <br />w <br />Flowmeter <br />TIME IN <br />PERMITILICENSE <br />Q <br />Gauges <br />91 <br />PROGRAM/ELEMENT <br />SERVICE <br />TIME OUT <br />I- <br />Skimmer & Gutters <br />GIC <br />13. <br />�I I/lQ <br />RATE OF FLOW <br />O <br />pH <br />CL <br />TEMP <br />OTHER <br />b <br />Water Supply & Quality <br />LU <br />¢ <br />Pipe d Fittings <br />19 <br />a ' 01 <br />The marked items represent Health Code violations and must be corrected as <br />follows: <br />ZE?U. <br />STR <br />OPER <br />N <br />t P4 <br />Z <br />Finers <br />1 <br />2 <br />a <br />Pumps <br />3 <br />4 <br />CLA ,e/ e <br />5, <br />6. <br />= <br />Chlorinator <br />w <br />Flowmeter <br />7 <br />8 <br />Q <br />Gauges <br />91 <br />10 <br />11 <br />12 <br />I- <br />Skimmer & Gutters <br />GIC <br />13. <br />14 <br />Back Flow Prevention <br />O <br />Waste Water Prevention <br />15r <br />16 <br />17 <br />18 <br />Water Supply & Quality <br />LU <br />¢ <br />Pipe d Fittings <br />19 <br />1 <br />O <br />Pool Shea <br />611 r4owilerd <br />20 <br />21' <br />'22 <br />iU <br />Bottom 8 Sides <br />5 n - It,yo c•rA, m a IK14 <br />TYtP <br />P OFFICE ADDRESS s'�� JQ��r <br />445 N. SAN JOAOUIN ST., STOCKTON, CA <br />(NO (NAIL IS RECEIVED AT THIS ADDRESS) <br />PHONE (209) 468-3420 <br />RECEIV DBY: <br />SANITARIAN: <br />23 <br />h24 <br />00¢ <br />Decking 8 Coping <br />25 <br />26.. <br />F- <br />Diving Boards <br />Fissure Pole <br />27' <br />28: <br />Z <br />Life Rings <br />29i <br />130,, <br />LU <br />Safety signs <br />31; <br />32' <br />a <br />Lifeguard <br />33� <br />Lighting Elm. <br />34 <br />35. <br />Lu <br />Ladders <br />36' <br />37'. <br />LL <br />Depth Markets <br />38 <br />39' <br />40i <br />41'. <br />y <br />First Aid Kits <br />Gas Masks <br />TZ <br />43 <br />1-0 <br />Showers <br />444 <br />145 <br />w0 <br />Toilet 6 Grassing <br />46 <br />47 <br />¢M <br />Ventilation <br />481 <br />49 <br />Chlorine <br />50 <br />PH <br />51' <br />Oa <br />Cyanurates <br />52' <br />aO <br />Clarity <br />53; <br />Test Kits <br />5541 <br />¢ <br />supervision a control <br />55 <br />LU <br />¢ <br />General Sanitation <br />56, <br />O <br />Miscellaneous <br />57' <br />POOL STATUS: (MARK ONE) <br />58 59 60 61 <br />62 <br />E[] GD F[] P❑ <br />C� <br />The marked items represent Health Code violations and must be corrected as <br />follows: <br />ZE?U. <br />r e <br />t P4 <br />Le r�OAJ IP u r r <br />1 <br />P <br />Irl <br />1111 V. r v` <br />rt C)n '- In <br />CLA ,e/ e <br />Z <br />9 <br />Zo �vLue `n � <br />r <br />D oi;r F(upr r 2 <br />r <br />GIC <br />ti C <br />U L 31,614 / r <br />1 <br />611 r4owilerd <br />ri�r <br />Zai <br />r^ <br />504 -C --a2- In <br />OP4 <br />5 n - It,yo c•rA, m a IK14 <br />TYtP <br />P OFFICE ADDRESS s'�� JQ��r <br />445 N. SAN JOAOUIN ST., STOCKTON, CA <br />(NO (NAIL IS RECEIVED AT THIS ADDRESS) <br />PHONE (209) 468-3420 <br />RECEIV DBY: <br />SANITARIAN: <br />1 <br />PAGE OF <br />2188 <br />