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Pg�ln. SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />FO <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: r 6 <br />n ; — 17Q r� P! I S Gh o <br />Date. - <br />Address: �� j),) <br />tovi#ll <br />AVC city: <br />T/rnC <br />Zip Code: 763X76 <br />Owner/Operator: cl 1 <br />a Tr ct c y <br />Telephone: (j J /- 6 z G I <br />Program Element: 3G <br />Program Record: - <br />6 o 1 SS <br />Inspection Type: 900 1 � rC <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />� Weo )�.5 <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />\ <br />�� e <br />n <br />l e Cure i <br />o en) <br />El PUMPS <br />1 <br />fl, 3 <br />'G(c�lorS - <br />n A ro w <br />❑ Chlorinator <br />❑ Flowmeter <br />G r c( <br />cert h rc q <br />�l <br />14CI4R n <br />❑ Gauges <br />U I (n <br />) i o r, <br />S C'( U re i n <br />P P �. <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />a <br />I <br />U ,) p -t 4 <br />O 6 G u h <br />I <br />e r cl d 1 h <br />[I Main Drain Cover <br />pool <br />C I Pm n t ✓1 3 <br />Oe e <br />El Equalizer Line Cover <br />CONSTRUCTION -- <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT. _ <br />❑ Rescue Pole <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth MarkersMles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />tt <br />dtc� <br />C4I� <br />7 Ur' 40 0 <br />h <br />WATER QUALITY <br />❑ Chlorine <br />Pur <br />Ur <br />iU�� u / ✓t P. <br />❑ pH <br />6u) <br />r <br />U spy <br />✓: (c . <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Time In: <br />Received By: <br />Ins®peec�te-d by-/-/,/� <br />Time Out: <br />EHD 36-01 5-8-12 SWIMMING POOL OR y Page __ of <br />