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e. �+ ... SAN JOAQUIN COUNTY <br />'.� ENS ,,DNMENTAL HEALTH DEPARTN T <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />o Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: <br />0 041f <br />Address: VI" <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: <br />Inspection Type: <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />1,0 it <br />0,0 au <br />Cyanuric Acid (ppm): <br />Io0 <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safet <br />Code Violations and must be corrected as indicated: <br />❑ Filters <br />tel/ <br />❑ Pumps <br />❑ Chlorinator❑ Flowmeter <br />(n <br />r❑ <br />A <br />Gauges <br />P�11 <br />WvA:4/� , <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />„a ., „ <br />L &lk <br />L <br />AA_ <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />.CONSTRUCTION <br />Pool Shell <br />_❑ <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 MarkerslTiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />-=.RESTROOMS <br />- <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 />Influent: <br />_1 <br />Effluent: 1' <br />Time In: "7�� <br />Time Out: <br />Re eiv <br />Inspected by: <br />EHD 36-015-8-12 SWIMMING POOL OIR Pagc <br />