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,P...fn. SAN JOAQUIN COUNTY <br /> B tONMENTAL HEALTH DEPART _NT <br /> (=: 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: - Date: <br /> Address: m me City: Zip Code: S <br /> Owner/Operator: C_ Telephone: S' -S <br /> Program Element: ( Program Record: (i,rD 3(�, Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: Pn ot4^°� <br /> RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must.be corrected as indicated: <br /> ❑ Fillers <br /> ❑ Pumps Fasf PoO I <br /> ❑ Chlorinator C 4-110 0-k '- Ca rri c <br /> ❑ Flowmeter <br /> ❑ Gauges FC- 9.2- GG <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention a <br /> EI Main Drain Cover ITU <br /> ❑ Equalizer Line Cover F C 9 -c C C O <br /> s- <br /> c.0 rre�-Ic <br /> El Pool Shell O v r }} , • _ _ _ <br /> ❑ Fencing/Gates _j_k4 I C <br /> ❑ Decking &Coping <br /> ❑ Wade Pool-2 Main Drains <br /> 'SAFETY EQUI PMENT 1 <br /> S I$1�. <br /> ❑ Rescue Pole p <br /> ❑ Life Ring d K 1p 8 r <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting K)0 ?-_4 <br /> ❑ Ladders/Hand Rails T'4 r I ;Lf t <br /> ElDepth Markers/Tiles <br /> ❑ First Aid Kits • O (f, & cLep /C)Z) <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑_ Showers 0,K +o rP - o e n e e'a -1 <br /> ❑ Toilet& Dressing 1 <br /> ❑ Ventilation IA-/0 -1K_ &Y-1 +k - 1.0`"_)f •7 -b) l o +l (e's + cL <br /> WATER QUALITY 'p0 Y-Y� 0015 <br /> ❑ Chlorine <br /> ❑ pH LLy +w-ve✓l I. rJ <br /> PP r-n <br /> ❑ Cyanuric Acid ® I} CJ 2 Jp¢ 7- a 8 a <br /> ❑ Clarity � 1 <br /> El Kits Oi YI UYi G (PV-U S n d.P r d0 •D' 7D / <br /> MISCELLANEOUS <br /> ❑__Supervision& Control <br /> ❑ General Sanitation /� <br /> El rc r� i r2� Tt= a 00 1-S <br /> Influent: <br /> Time In: Z Received By: Inspec{,te�d by: <br /> Effluent Time Out: to'. 15 <br /> �J �""- �"�� <br /> EHD 36-017-31-09 SWIMMING POOL OIR1'S3-�I� Page I of� <br />