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SAN JOAQUIN COUNTY <br /> 0P uly.. - <br /> '" EN rTONMENTAL HEALTH DEPART NT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: XLA— Date: if / <br /> Address: city: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: 7j <br /> Lr qj Program cord: V 3 b 0 -3 Inspection Type: <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 /> ❑ Filters14 a <br /> ❑ Pumps OU�-C ./K./ <br /> ❑ Chlorinator C <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell _ <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping _ <br /> ❑ Wade Pool—2 Main Drains <br /> '- <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ PooVDeck Lighting <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergencv Shut-off Switch <br /> REST.ROOMS <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: I <br /> Received By: Inspected by: <br /> Effluent: / <br /> Time Out: ��/ zr��v^d— <br /> EHD 36-015-6-12 SWIMMING POOL OIR Page of <br />