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SAN JOAQUIN COUNTY p � P <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: 209 468-3420 Fax: 209 468-3877 Web:www.s gov.org/ehd P Cr <br /> p � ) � ) J9 9 <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT 04C—e <br /> Name of Facility: -Q _\—Y Date: o . 2 • 29 <br /> G <br /> Address: 2 C �I City: � � Zip Code: S3"j <br /> Owner/Operator: Telephone: 2�3cl <br /> Program Element Program Record: (-\e Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm); Cyanuric Acid Temp: Other: Reinspectiob on or after: <br /> (ppm): <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) 115043, 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 ❑ ❑ ❑ 35 Flow Meters ❑ D <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 9[:] ❑ ❑ 44 Lifeguard Certification ❑ ❑ <br /> 11 Combined Chlorine Concentration ❑ ❑ 45 Lifeguard First Aid Equipment ❑ ❑ <br /> 12 pH Level ❑ ❑ ❑ 999 1 Other ❑ ❑ ❑ <br /> 13 Cyanuric Acid Concentration ❑ ❑ ❑ <br /> 14 Chemical Water Test Kit ❑ ❑ CN 2'. 1 5 <br /> 15 Operation Records ❑ ❑ p 2 <br /> 16 Water Clarity ❑ ❑ ❑ <br /> 17 Cleanliness of Pool ❑ ❑ I { <br /> 18 Pool Shell and Tile ❑ ❑ - 5 C <br /> 19 Depth Markers ❑ ❑ <br /> 20 Depth Marking Line ❑ ❑ <br /> 21 Water Level ❑ ❑ <br /> 22 Skimmer Assembly ❑ ❑ <br /> 23 Pool Inlets and Outlets ❑ ❑ <br /> 24 VGB Suction Covers ❑ ❑ ❑ <br /> 25 Spa Emergency Shut Off Switch ❑ ❑ ❑ Q G� <br /> 26 Spa Operating Temperature ❑ ❑ ❑ <br /> 27 Pool Equipment Room ❑ ❑ <br /> 28 Safety Vacuum Release System ❑ ❑ ❑ ` <br /> 29 Recirculation System Operation ❑ ❑ ❑ <br /> 30 Pool Equipment&Plumbing Maintained ❑ ❑ <br /> 31 Disinfectant Feeders El ❑ GC <br /> 32 Chemical Control and Monitoring System El ❑ J v�`CZy'Y\S r <br /> 33 Minimum Turnover Time El <br /> 34 Maximum Flow Rats ❑ ❑ A <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 T+me Out Received By: —T—r lnspected By: <br /> EHD 36-01 Rev,08/06l16 Page 1 of SWIMMING POOL OIR <br />