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>n° SAN JOAQUIN COUNTY <br /> D ZONMENTAL HEALTH DEPARTI JT <br /> • 600 East Main Street, Stockton, CA 95202-3029 <br /> ;Fo a Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1A 6�G�(,�, 0-RI S Date: �( <br /> Address: e li- City: 6 Zip Code: "V <br /> Owner/Operator. Telephone: <br /> Program Element: Program Record: Inspection Type:AS OX <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after. <br /> Other: <br /> th' Aa �AMIE The marked violations re res nt Ith& Safety Code Violations and must be rected as indicatedFil : <br /> ers <br /> E3Pumps -0�2 <br /> ❑ Chlorinator p({ S 42Pf <br /> ❑ Flowmeter f D! <br /> ❑ Gauges / WAR <br /> E] Skimmer&Gutters 04.X <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover PMIAM1090 <br /> ❑ Equalizer Line Cover <br /> yy'�,' �s"'i"�rn.�i'q-,TR.G r-O' 9n, y i <br /> ElPool Shell " .JQ - <br /> ❑ Fencing/Gates 9 * (1)4tf, Ttv <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains <br /> ❑ Rescue Pole <br /> ❑ Life Ring u' <br /> ❑ Safety Signs <br /> ❑ Lifeguard �n , <br /> '`r <br /> ❑ Ladders/Hand <br /> Lid Rail a-, , ,¢qty . O <br /> ❑ Depth s/ rker Rails n COU4-❑ Depth Markers/Tiles � <br /> ❑ First Aid Kits �>1Q QK(L41fc ph_ n) <br /> ❑ Emergency Shut-off Switchj <br /> EEL 1 .cox bt?n� <br /> ❑ Showers 000 /DreE1Q 451*0 . <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation <br /> VC/AM- (9u _ <br /> OAt <br /> ❑ Chlorine0 pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity i <br /> ❑ Test Kits l� <br /> sm"-ts <br /> ear .o AO 31D� <br /> ❑ Su ervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: 11 <br /> p66t3� T <br /> f <br /> (i� �'; ttimeln: Re eived By: nspected by: <br /> Effluent: Time Out: p�+),eL V-.1 e „b3?) <br /> EHD 36-017-31-09 SWIMMING POOL OR Page of I <br />