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ip <br /> SAN JOAQUIN COUNTY <br /> EN'V )NMENTAL HEALTH DEPARTM, r <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-E232 <br /> Telephone:.(209) 468-3420 Fax:(209)468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: S' Date: 1 Ny —� <br /> Address: Ntr wt— City: Zip Code: 8521 p <br /> Owner/Operator: r-2 /ITelephone: <br /> Program Element: ( f 'Z Program Record: c> �j ZLl Inspection Type: /Q <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 <br /> ❑ Chlorinator CLQ,(tit <br /> ❑ Flowmeter e <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention �L <br /> E] Main Drain Cover t <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping �1I <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 /> 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 /> Time In: t J ecei ed By: Inspected by: <br /> Effluent: <br /> Time Out: I . + 524 <br /> t,(L � <br /> EHD 36-015-8-12 SWIMMING POOL OIR Page_of <br /> t <br />