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SWIMIV a POOL OFFICIAL INSPECTION " -PORT <br />SAN JO#�JUIN COUNTY PUBLIC HEALTH �_RVICE <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 2009, STOCKTON, CA 95201 <br />BUSINESS ADDRESS <br />i <br />STR <br />DATE <br />/ D 9 <br />OWNER'S NAMEIDSA <br />Filters <br />1 <br />2 <br />COM ER NUMB <br />4 <br />a <br />Pumps <br />5 <br />6 <br />MAILING ADDRESS <br />Chlorinator <br />Ow <br />Flowmeter <br />yy c/ieA. <br />TIME IN <br />8 <br />�L <br />Gauges <br />9 <br />10 <br />PERMITILICENSEPROfj <br />12 <br />RAMIELEMENT <br />D 6-1 <br />SERVICE <br />TIME OUT <br />Back Flow Prevention <br />RECEIVED UT: <br />t <br />ill Ai <br />�J(6 <br />PAGE ( OF <br />o <br />9211 <br />1 <br />PATE OF FLOW <br />18 <br />pH <br />Water Supply & Quality <br />CIL. <br />TEMP <br />OTHER <br />r <br />i <br />STR <br />OPER <br />Z w <br />Filters <br />1 <br />2 <br />3 <br />4 <br />a <br />Pumps <br />5 <br />6 <br />D <br />Chlorinator <br />Ow <br />Flowmeter <br />yy c/ieA. <br />7 <br />8 <br />OZ <br />Gauges <br />9 <br />10 <br />11 <br />12 <br />Skimmer & Gutters <br />D 6-1 <br />13 <br />14 <br />Back Flow Prevention <br />RECEIVED UT: <br />t <br />ill Ai <br />Waste Water Prevention <br />PAGE ( OF <br />15 <br />116 <br />17 <br />18 <br />Water Supply & Quality <br />UJ <br />Pipe & Fittings <br />19 <br />ZO <br />Pool Shell <br />20 <br />zl­ <br />OOQ <br />Bottom & Sides <br />21 <br />22 <br />23 <br />24 <br />Decking & Coping <br />25 <br />26 <br />Diving Boards <br />Resure Pole <br />27' <br />28 <br />Z <br />Life Rings <br />29'. <br />30 <br />i <br />Safety Signs <br />31 <br />32 <br />GLifeguard <br />33. <br />34' <br />•35 <br />OLighting <br />Else. <br />36 <br />37 <br />Ladders <br />38 <br />39' <br />a <br />Depth Markers <br />40 <br />41, <br />W <br />First Aid Kits <br />42. <br />43 <br />Gas Masks <br />�to <br />Showers <br />44. <br />45 <br />46 <br />47 <br />VI <br />Toilet & Dressing <br />¢2 <br />ventilation <br />48, <br />49, <br />Chlorine <br />50 <br />PH <br />51 <br />O< <br />Cyanuratea <br />52'. <br />flQ <br />Clarity <br />51 - <br />Test Kits <br />54! <br />cc <br />Supervision & Control <br />55' <br />w <br />S <br />General Sanitation <br />56'. <br />O <br />Miscellaneous <br />571 <br />POOL STATUS: (MARK ONE) <br />58 59 60 <br />61 <br />62 <br />E[] G[] F[] <br />P❑ <br />C� <br />The marked items represent Health Code violations and must be corrected as <br />follows: <br />i <br />7 S <br />_ <br />e <br />yy c/ieA. <br />W � <br />r <br />CVA <br />Y!%). Y <br />D 6-1 <br />OFFICE ADDRESS <br />445 N. SAN JOApUIN ST., STOCKTON, CA <br />(NO MAIL IS RECEIVED AT THIS ADDRESS) <br />PHONE (209) 468.3420 <br />RECEIVED UT: <br />t <br />ill Ai <br />SANTA IAN. <br />PAGE ( OF <br />2180 <br />