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SAN JOAOUIN COUNTY <br />w� <br />ENVIRONMENTAL HEALIN DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />"'•;•.6= Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />S IMMING OOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: / <br />Address: City: /Z Zip Code: J 3 7 <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: (o <br />Flow Rate (gpm): <br />PH <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspeiftion on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />T m ked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps/ <br />0 <br />(,(CQZt(%i�/ <br />❑ Chlorinator <br />El Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover _ <br />❑ Equalizer Line Cover <br />A(Q <br />CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool — 2 Main Drains <br />SAFETY EQUIPMENT <br />r <br />❑ Rescue Pole <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ POOUDeck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />- R£STROOMS <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 />Zro <br />Influent: <br />Effluent: <br />Timeln: <br />Received By: <br />I s e ed by: <br />Time Out: g <br />EHD 36-015-8-12 SWIMMING POOL OR Page of <br />