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SAN JOAQUIN COUNTY <br /> Er RONMENTAL HEALTH DEPART NT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> kpa Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: -' S ttia re' Date: -D <br /> Address: o-�) — rrLe "�, City: Zip Code: q .J (O <br /> Owner/Operator: ```7 �L r-\ 9 h Telephone: qrj _c, <br /> Program Element:' (� t Program Record: G1 I -Z Inspection Type: 2_Y1 el l2 <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspectiorl on or after: <br /> Other: <br /> -AECI.RCULATION.EQUIPMENT;; The marked violations represent Health &Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters I <br /> ❑ Pumps ✓ �7 O U <br /> ❑ Chlorinator Pd 7 . L A (q a <br /> ❑ Flowmeter <br /> ❑ Gauges G QJ-e r;tO GG <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover Uje S L^ 1 <br /> CONSTRUCTION TIQN 4 ' - C 14 too <br /> ❑ Pool Shell � T_- - <br /> ❑ Fencing/Gates - Fe, 7 �C <br /> ❑ Decking& Coping <br /> ❑ Wade Pool-2 Main Drains <br /> ".'SAFETY EQUIPMENT D_ -�o e_ in R&,n PO <br /> ll <br /> ❑ Rescue Pole <br /> ❑ Life Ring O✓ d <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting r4-K o I t <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles - <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> _RE;S,7RQO; S <br /> ❑ Showers ©L+ - L <br /> ❑ Toilet& Dressing <br /> ❑ ventilation Loar14 +o re--o ori no r-4h <br /> poo <br /> WATER QUALITY <br /> ❑ Chlorine <br /> ❑ pH - <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> " MISCELLANEOUS <br /> _❑ Supervisinn & Control <br /> ❑ General Sanitauon <br /> ❑ Algae <br /> Influent: <br /> Timeln: ` Rec eed By: Inspected by: <br /> Effluent: .n �D <br /> Time Out: to 'OD <br /> EHD 36-01 7-31-09 SWIMMING POOL OIR Page for 1 <br />