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ufn.. SAN JOAQUIN COUNTY <br />w < <br />E 9RONMENTAL HEALTH DEPAF" 'ENT <br />1868 East Hazelton Avenue, Stockton, CA 9005-6232 <br />;ko Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />C ay(" <br />Date: to <br />Address: dL Vq 0 LA7 <br />4ik ( V\tlL City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: 70. —/ <br />Program Element: Program Record: Q:f� <br />Inspection Type: <br />Flo \ ate (gpm): <br />V v <br />pH:� <br />Cgrfnet(pr): <br />y/1 <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & SafetyCode Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />��t1 p� x,�, <br />ctAl2 <br />❑ Chlorinator <br />❑ Flowmeter <br />6Y �A4ww <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />p,PcAq <br />Ul�it� <br />Oct- <br />❑ Main Drain Cover <br />flDh�e CUAALA-tL4 <br />'U 012 <br />❑ Equalizer Line Cover <br />v CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />62_j � <br />vY` <br />AR <br />a <br />n- I <br />A q6OAv" — ' <br />4 <br />❑ Wade Pool — 2 Main Drains <br />'. SAFETY EQUIPMENT <br />F-1 Rescue Pole <br />EF -Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />✓ u <br />❑ Pool/DeckLighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />RESTROOMS <br />- <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />I. MISCELLANECIIS :- .:• <br />❑ Supervision & Control <br />--- <br />❑ General Sanitation <br />❑ Algae <br />Influent: 1 <br />Effluent: � <br />Time In: ` <br />7 <br />: <br />Race1:; <br />Inspected by: <br />Time Out: <br />EHD 36-015.8.12 SWIMMING POOL OIR Page of <br />