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P.�n.. SAN JOAOUIN COUNTY <br /> q� < <br /> EN\j..iONMENTAL HEALTH DEPARTMuAT <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: -F.U� Date: It-'g- <br /> Address: <br /> 'Address: Q Is:, ,kcity: Zip Code: c'y SZ I c.- <br /> Owner/Operator: <br /> Owner/Operator: r-Z ,7 Telephone: <br /> Program Element: 4, r 2_ Program Record: O °j -Z,(�2 --3. Lt 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 /> ❑ Filters <br /> ❑ Pumps <br /> ❑ Chlorinator <br /> ❑ Flowmeter r <br /> ❑ Gauges e 4-%,C-12— <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover F S igdk -* 2 <br /> ❑ Equalizer Line Cover C` v. ,i-. •✓-� ,��� <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates ALU r-,o-- Irk v.,*-f` <br /> ❑ Decking&Coping y /rr J ' <br /> El � <br /> Wade Pool-2 Main Drains (A 40 ✓, 'Tt4d ( S <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/files <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: C( J ecei ed By: Inspected by: <br /> Effluent: � A `r <br /> Time Out: ( � � � / % 1 , �.JLQ�syy <br /> EHD 36-01 5-8-12 SWIMMING POOL 018 hJ Page_of <br />