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SAN JOAQUIN COUNTY <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> 4Cl F O aN <br /> SWIMMING POOL OFFICIA-L INSPECTION REPORT <br /> Name of Facility: olo Ro f} Date: 7� Z <br /> Address 6 �' ity: Zip Code: <br /> Owner/Operator: '7 - 4/// <br /> �C Telephone: t/7 8 C <br /> Program Element: 36-11 Program Record: !g U Inspection Type: <br /> Flow Rate(g S� pH: -7 z/ /�aOL p av Cyanuric Acid(popom� Temp:9 y' <br /> 6 OF Reinspection on or atter: <br /> o §r --P°oL� 2,- 7, G spa 7 'p!m 3o fv Ps�� Other: <br /> RE CIRCULA TION!EQUIPIMENT: The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps <br /> b Chlorinator <br /> ` ❑ Flowmeter - <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover 6 6(/ Y d'es f— <br /> CONSTRUCTION.;: <br /> ❑ Pool Shell �7 <br /> ❑ Fencing/Gates pdL <br /> ❑ Decking&Coping �t <br /> ❑ Wade Pool-2 Main Drains �� M oC 72 M P ., <br /> ` S ATF,TY EQ 01PMEN:T <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting s G( P/f - Z- C c /R10 G <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits I Fr- Chi lb ;s- 141w <br /> ❑ Emergency Shut-off Switch <br /> t-:'^"-a,-.a.--`,RESTROOMSir.,c _f^..,mow; J� Gcl Ao .�O /-✓joC//J�-c[i (y(LDY� <br /> ❑ Showers - <br /> ❑ Toilet&Dressing / <br /> ❑ Ventilation e <br /> WATER:QUALITY,,,.c<. <br /> ❑ Chlorine , <br /> ❑ 4 pH � d 4Z -6 l-,q5 a Lo w�0//-L <br /> ❑. Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits Po(} S ` <br /> ` CV, MISCELL'ANEOUS *'. <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae w <br /> 3A3i <br /> Influent: <br /> p /y� Time In: �/;� Recut ed y: Ins d by: <br /> Effluent: Sri r( Time Out: <br /> _ <br /> G <br /> EHD 36-01 5/26/05 <br /> Page_of <br />