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„4 t SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 468-3877 Web:www.sjgov,org/ehd <br /> Y1 e eels <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT -Q-f�� <br /> Name of Facility: ,� (�e C� C Date: <br /> Address: City: 4 h Zip Code: <br /> OwnerlOperator: Telephone: <br /> Program Element: �j 1 ` Program Record: e e Inspection Type: <br /> CD <br /> Flaw Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid Temp: Other. Reinspectio on or after. <br /> .�or1z: + . �0 S . In cP�3 .� Comb. 1 sf -kzz� <br /> MAJ=Major Violation OUT=Not in Compliance COS=Corrected on-site <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. Items listed on this report as violations do not <br /> meet the requirements set forth in the California Health and Safety Code section(s) 116043, 116040.&116050. All violations must be corrected within <br /> specified timeframe. Violations that are classified as"MAJOR”pose an immediate threat to public health and must be corrected immediately or be subject to <br /> closure pursuant to Califomia Code of Regulations(Title 22)section 65545. <br /> VIOLATION MAJ OUT COS VIOLATION MAJ OUT COS <br /> 1 Pool Gates ❑ ❑ ❑ 35 Flow Meters ❑ <br /> 2 Pool Enclosure ❑ ❑ ❑ 36 Pressure and Vacuum Gauges ❑ ❑ <br /> 3 Safety Signs ❑ ❑ 37 Electrical Hazards ❑ ❑ <br /> 4 Safety Equipment ❑ ❑ ❑ 38 Filter Cleaning and Maintenance ❑ ❑ <br /> 5 Restrooms and Showers ❑ ❑ 39 Wastewater Disposal ❑ ❑ <br /> 6 Hose Bibb Anti Siphon Device ❑ ❑ 40 Spray Ground UV Disinfection ❑ ❑ ❑ <br /> 7 Pool Deck ❑ ❑ 41 Spray Ground Pumps Interconnected ❑ ❑ ❑ <br /> 8 Pool Deck and Lighting ❑ ❑ 42 Spray Ground Recirculation System ❑ ❑ ❑ <br /> 9 Ladders and Handrails ❑ ❑ 43 EHD Approval Required ❑ ❑ ❑ <br /> 10 Disinfectant Residual ❑ ❑ ❑ 44 lifeguard Certification ❑ ❑ <br /> 11 Combined Chlorine Concentration ElEl45 Lifeguard First Aid Equipment El El12 pH Level ❑ ❑ ❑ 999 Other ❑ El ❑ <br /> 13 Cyanuric Add Concentration ❑ El El <br /> 14 Chemical Water Test Kit ❑ ❑ <br /> 15 Operation Records ❑ ❑ <br /> 16 Water Clarity ❑ I] ❑ `C <br /> 17 Cleanliness of Pool ❑ ❑ <br /> 18 Pool Shell and Tile ❑ ❑ <br /> 19 Depth Markers ❑ ❑ ` <br /> 20 Depth Marking Line ❑ ❑ l <br /> 21 Water Level ❑ El l Q A-\D c 0r r e <br /> 22 Skimmer Assembly ❑ 1 +� S CI ��Q <br /> 23 Pool Inlets and Outlets ❑ 1 <br /> 24 VGB Suction Covers ❑ ❑ ❑ ` - <br /> 25 Spa Emergency Shut Off Switch ❑ ❑ ❑ 2-2 3 7hr'e4 0'(7 .mmerS <br /> 26 Spa Operating Temperature ❑ ❑ ❑ <br /> 27 Pool Equipment Room ❑ ❑ <br /> 28 Safety Vacuum Release System ❑ El El \,)`��sz v.)Qe�CS. Of'\e 0- <br /> F <br /> 29 Recirculation System Operation ❑ ❑ ❑ <br /> 30 Pool Equipment&Plumbing Maintained am ❑ ❑ <br /> 31 Disinfectant Feeders ❑ ❑ ❑ <br /> 32 Chemical Control and Monitoring System ❑ ❑ <br /> 33 Minimum Turnover Time ❑ ❑ <br /> 34 Maximum Flow Rate ee-r � <br /> RM ❑ ❑ <br /> ALL EHD STAFF TIME ASSOCIATED WITH BRINGING THIS FACILITY INTO COMPLIANCE,INCLUDING REINSPECTIONS,WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> Time In: Time Out Received By: -.A-rQ f-4p Inspected By: <br /> EHD 36-01 Rev.681178116 Page 1 of 2- SWIMMING POOL OIR <br />