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a�+iy SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazefton Avenue, Stockton, CA 95205-6232 (\e e-6 ed <br /> ;o Telephone.(209) 468-3420 Fax: (209) 468-3877 Web:www.sjgov.org/ehd Y-\2e-65 <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT P JZ��N � <br /> Name of Facility: C),,Q(\e Date: b • 20 • Zq <br /> Address: '�L� C �� City: Zip Code: <br /> Dwnerlopemtor: Telephone: 12-C�0( . 1-� , �d <br /> Program Element: `�tp`` Program Record: <2�QXA Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid Temp: Other: Re•nspectio on or after. <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 California Code of Regulations(Title 22)section 65545. <br /> VIOLATION MAJ OUT COS VIOLATION MAJ OUT COS <br /> 1 Pool Gates ❑ ❑ ❑ 36 Flow Meters ❑ <br /> 2 Pool Enclosure ❑ ❑ ❑ 36 Pressure and Vacuum Gauges ❑ ❑ <br /> 3 Safety Signs ❑ ❑ 37 Electrical Hazards 7X L] ❑ <br /> 4 Safety Equipment ❑ ❑ ❑ 38 Filter Cleaning and Maintenance ❑ ❑ <br /> 5 Restroorns 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 ❑ ❑ 45 Lifeguard First Aid Equipment w" ❑ ❑ <br /> 12 pH Level ❑ ❑ ❑ 999 Other ❑ I ❑ ❑ <br /> 13 Cyanuric Acid Concentration ❑ ❑ ❑ <br /> 14 Chemical Water Test Kit ❑ ❑ 1-L1 e s <br /> 15 Operation Records ❑ ❑ 1 <br /> 16 Water Clarity ❑ ❑ ❑ 1 �� <br /> 17 Cleanliness of Pool ❑ ❑ <br /> 18 Pool Shell and Tile ❑ ❑ �\A <br /> 19 Depth Markers ❑ ❑ <br /> 20 Depth Marking Line ❑ 0 <br /> 21 Water Level ❑ ❑ P C or( Q 5t <br /> 22 Skimmer Assembly ❑ 1 !:c (2 CX <br /> 23 Pool Inlets and Outlets ❑ <br /> 24 VGB Suction Covers ❑ ❑ ❑ <br /> 25 Spa Emergency Shut Off Switch ❑ ❑ ❑ 22 �hre� 01F <br /> 26 Spa Operating Temperature ❑ ❑ ❑ <br /> 27 Pool Equipment Room ElEl `�Q4 r ��rs • �-+ <br /> 2a Safety Vacuum Release System ❑ ❑ ElJ'AQ V� e�j,` �(� 0-r <br /> 29 Recirculation System Operation ❑ ❑ ❑ Sk^� (YNf`{1 lo>,� <br /> 30 Pool Equipment&Plumbing Maintained ❑ ❑ t ` <br /> 31 Disinfectant Feeders ❑ ❑ ❑ <br /> 32 Chemical Control and Monitoring System ❑ ❑ <br /> 33 Minimum Turnover Time ❑ ❑ 2�s .a ` <br /> 34 Maximum Flow Rate El ❑ o e' ` 2 Vl <br /> ALL EHD STAFF TIME ASSOCIATED WITH BRINGING THIS FACILITY INTO COMPLIANCE,INCLUDING REINSPECTIONS,WILL BE BILLED AT THE CURRENT HOURLERATE. <br /> Time In: Time Out: Received By: Inspected By. <br /> EHD 36-01 Rev.08/08/16 Page 1 of 2— SWIMMING POOL OR <br />