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00 SAN JOAQ COUNTY PUBLIC HEALTH S VICES
<br />E
<br />
<br /> NINTENTAL HEALTH DIVISI
<br />304 , ST WEBER AVENUE, THIRD FLOC,
<br />STOCKTON, CA 95202
<br />(209) 468-3420
<br />BUSINESS ADDRESS
<br />--- ' i -!.. 3 ..'•
<br />DATE ,
<br />I / I Li
<br />OWNERS NAME NAME /DB*
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<br />COMPUTER NUMBER
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<br />MAILiNG ADDRESS
<br />TIME IN
<br />PERMIT/ LICENSE PROGRAM I ELEMEN1
<br />- /
<br />SERVICE
<br />Ai
<br />TIME OUT
<br />RATE OF FLOW 04
<br />(
<br />ICL TEMP
<br />.1
<br />1
<br />OTHER
<br />(..1. \I A - e-- RECIRCULATION EQUIPMENT] SIR OPER
<br />Filtrors
<br />Pumps
<br />Chlorinator
<br />Flowmater
<br />Gauges
<br />Skimmer & Gutters
<br />Back Flow Prevention
<br />Waste Water Prevention
<br />Water supply I Quality
<br />Pipe & FlIngs
<br />1
<br />3
<br />5 1
<br />7 8
<br />9 10
<br />12 11
<br />13 14
<br />15 16
<br />17 08. -57N7:1 STRUCTIO. Pool Shell
<br />Bottom & Sides
<br />Decking & Coping
<br />Divot ifoards
<br />P i 20
<br />21 . . 22
<br />23 24
<br />25. 26 , __- SAFETY EQUIPMENT Rism&i Pole
<br />Ule Rings
<br />Sagely Signs
<br />Lifeguard
<br />lighting Elec.
<br />Loaders
<br />Depth Markers
<br />First Aid Kits
<br />Gas Masks
<br />27! 28 ,
<br />29' 30
<br />311 32
<br />7M433
<br />34! 35
<br />36' 37
<br />38 139 ,
<br />40. 141'
<br />42, 43
<br />0 1-2 cn “Jo
<br />cc 0 cc
<br />Showers
<br />Toilet & Dressing
<br />ventilation
<br />441 45
<br />4e 47
<br />48; 49.
<br />2 01
<br />Chlorine
<br />pH
<br />Cyanurates
<br />Clarity
<br />Test Kits
<br />50
<br />
<br />
<br />
<br />
<br />cc iii
<br />I 1 1-.
<br />I 0
<br />supervision & Control
<br />General Sanitation
<br />Miscellaneous
<br />
<br />56
<br />57,
<br />I POOL
<br />i
<br />'
<br />E
<br />58 E
<br />STATUS:
<br />59
<br />G
<br />(MARK
<br />F
<br />60 _
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<br />ONE)
<br />P
<br />61
<br />C
<br />62 E
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<br />The marked items represent Health Code violations and must be correctei, as
<br />follows.
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