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SAN JOAQUIN COUNTY <br />a� <br />'s ENVIKVNMENTAL HEALTH DEPARTMEIV I- <br />1868 <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />° Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sigov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: - <br />Date: lQ-10- 1 -3 <br />Address: l..t 0 '-'izd <br />city: <br />Zip Code: 9 !�iZ <br />Owner/Operator: <br />Telephone: q - <br />Program Element: 12 Program Re d:Inspection <br />Type: <br />Flow Rate (gpm): <br />lit (so" <br />pH: <br />2 <br />Chlorine (pp; )2 <br />C' C o. o <br />Cyanuric Acid (ppm): <br />> I o0 PPI' <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />Filters <br />�Cl-� ch 1 or- <br />lej e <br />l <br />1. Z <br />_ <br />4 -PUMPS <br />- <br />ET Chlorinator <br />[7I Flowmeter <br />Gauges <br />Skimmer & Gutters <br />Back Flow Prevention <br />S <br />1 <br />Main Drain Cover <br />( <br />e <br />[y Equalizer Line Cover <br />- 'INSTRUCTION <br />2 �• SO 1 An <br />i\0. <br />, <br />ear <br />Eq Pool Shell <br />\ <br />n <br />Fencing/Gates <br />Decking & Coping <br />❑ Wade Pool -2 Main Drains <br />r; <br />SAFETY EQUIPMENT <br />Rescue Pole <br />C <br />2 <br />[[� Life Ring <br />[v] Safety Signs <br />Lifeguard <br />5C <br />\ <br />EY Pool/Deck Lighting <br />Er Ladders/Hand Rails <br />fr <br />Depth Markers/Tiles <br />C\ <br />First Aid Kits <br />Emergency Shut-off Switch <br />''RESTROOMS-`--- <br />❑ Showers <br />❑ Toilet & Dressing iN 166 - <br />❑Ventilation <br />WATER QUALITY <br />[a' Chlorine �l <br />[� pH <br />❑ Cyanuric Acid <br />Clarity <br />Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: 9 <br />Effluent: Z <br />Time In: IA <br />Received By:Inspected <br />f'11' 1 I <br />by: <br />V . `1 r <br />Time Out: 12.20 <br />EHD 36-01 5-8-12 SWIMMING POOL OR Page — of <br />n <br />1r1 <br />