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SAN JOAQUIN COUNTY <br /> ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> a V i i <br /> . 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)468-3877 Web:www.sigov.org/ehd <br /> wtM-Ml G-P-©-o"L-o-F-Prei a�--II4-sY C-TtoOtz- <br /> Name of Facility: S mai,., -, N Date: —Z-j - <br /> Address: p City: Zip Code: O <br /> Owner/Operator: cyG 6 k c.-Q Ly-,.��—�{ Telephone: <br /> Program Element: 3 Z_ Program Record:- '7} 3 p Inspection Type: /Zug rte¢_ <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps W T <br /> ❑ Chlorinator / <br /> ❑ Flowmeter v�Z t S SC I S Ge <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover Tl� �L �U Cn <br /> ❑ Equalizer Line Cover 1 <br /> 5, o 1 p 4 r` r k ;' C— <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 Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑ Showers <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation <br /> WXTER 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 /> Time In: - IReceived By: Inspected by: r <br /> Effluent: Time Out: 2 /tj <br /> PHn3r-o15-8-12 SWIMMING POOL OIR Page-�of 3 <br />