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P° SAN JOAQUIN COUNTY <br /> )' G <br /> Q: <br /> ENVIkONMENTAL HEALTH DEPARTMEN I' <br /> �. 304 East Weber Avenue, 3`d Floor, Stockton,CA 95202-2708 <br /> Telephone: 209 468-3420 Fax: 209)464-0138 Web:www.s ov.or /ehd <br /> • c ... �P P � ) � Jg g <br /> 4��FOR� <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: �� Date: <br /> Address: c City: Zip Code: <br /> Owner/Operator: 4- D Telephone: 73 — Z -73 <br /> Program Element: 36 C( Program Record: 3 6 Q Inspection Type: �cw ` <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> G <br /> �Q IF8-/l� �.. e Z '7 10© Other: 9-257-Q6 <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters Q ' <br /> ❑ Pumps ` <br /> ❑ Chlorinator �Q_ <br /> ❑ owmeter L <br /> Gauges Q� <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> [R Main Drain Cover <br /> ❑ Equalizer Line Cover 3 477 <br /> CONSTRUCTION �< <br /> ❑ Pool Shell <br /> ❑ Fencing/Gatesnil <br /> � 7�Q� _ r7�,I <br /> ❑ Decking&Coping <br /> ❑ Wade Pool-2 Main Drains / ►� <br /> SAFETY EQUIPMENT 40 <br /> ❑ Rescue Pole <br /> ❑ Life Ring .3a D _ <br /> �Safety Signs <br /> ❑ Lifeguard b <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails a � <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑ Showers <br /> ❑ Toilet&Dressing /� ' <br /> El Ventilation <br /> `�f <br /> n <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: +t Re eked ftV: Inspecte <br /> Effluent: <br /> Time Out: I'� <br /> EHD 36-01 5/26/05 Page of <br />