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-aur SAN JOAQUIN COUNTY <br /> ENVI'KUNMENTAL HEALTH DEPARTML <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: ?d 2-el/ <br /> Address: City: �' Zip Code: �a <br /> Owner/Operator: V Telephone: Af.!� -7 -321/,0 <br /> Program Element: 1 Program Record: ,R- 43 Inspection Type: EDAh Ya <br /> Flow Rate(gpm): pH: Chlo`i D(pp9�): /{3`j i Other:Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> I <br /> —7• 2, V 1, " <br /> ji: ti?� � I Them rked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> El Filters ' / " I , t 641` Y 1 / <br /> ❑ Pumps �Y� lQcYIK <br /> ❑ Chlorinator j�a <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> ❑ Pool Shell - _. <br /> ❑ Fencing/Gates <br /> ❑ Decking &Coping <br /> ❑ Wade Pool-2 Main Drains <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 /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> ❑ Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> ❑ Supervision&Control <br /> ❑ General Sanitation /� ,�/ <br /> ❑ Algae /;�U .! �WID� '� /��` f i� ► 1 q4V-�,�yn�? V C 8 WLR /® <br /> Influent: C 9 �l7lJ y �CC`1 x4hvtfeW /oaf lYI � vkf '"`� e <br /> � ) <br /> Time In: Received By: Inhipected by: <br /> Effluent: Time Out: <br /> EHD 36-01 7-31-09 SWIMMING POOL OIR Page of <br />