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I PpUrN SAN JOAQUIN COUNTY <br /> ENVIN JNMENTAL HEALTH DEPARTME._. <br /> t 304 East Weber Avenue, 3 d Floor, Stockton, CA 95202-2708 <br /> ,.P. Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> q[iFOPa <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: -.2 C ,p <br /> Address: Z Zip Code: <br /> Owner/Operator: J Telephone: -q -f ,j <br /> 31 Program Element: 3LProgram Record: 19R 3 (p Q Q41 Inspection Type: �h <br /> •y Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> FC = 6, <br /> <SS 7 CC /OU Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps _ /_ / <br /> E] Chlorinator 0-01a�;O//S ha'ye �� /'I do/''e-a� <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Ganes Y:p s' <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool—2 Main Drains <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑ Showers <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation <br /> WATER QUALITY <br /> ❑ Chlorine <br /> ❑ PH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: ��fy <br /> p• <br /> EfflucnC Timeln: a : 0 lza� t* <br /> By- , In c e by: <br /> O ��y <br /> TimeOut: 3:00;:] <br /> ;Oi7—!n <br /> EHD 36-01 5/26/05 Page_of_ <br />