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o� SAN JOAQUIN COUNTY <br /> ENVIf.JNMENTAL HEALTH DEPARTME.. I' <br /> " 600 East Main Street, Stockton, CA 95202-3029 <br /> • �4C%FOQ?P <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: 77 p'p, <br /> Program Element: 13 Ob Program Record: C00 Q (J 6 Inspection Type: < <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Rei spection on or after: <br /> Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health &Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> DLl9 <br /> ❑ Pumps zj <br /> ❑ Chlorinator ae.0 e <br /> ❑ Flowmeter c <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover <br /> CONSTRUCTION IV <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool–2 Main Drains <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole t <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 Q Dlivr7 <br /> ❑ Clarity <br /> Test Kits ! <br /> MISCELLANEOUS Q -AG7^ C.f� <br /> ❑ Supervision &Control y <br /> ❑ General Sanitation <br /> ❑ Algae OF <br /> Influent: <br /> Time In: 7/ 75— Received By: Ins a ted by: <br /> Effluent: Time Out: p(.. ,(� <br /> EHD 36-01 7-18-08 SWIMMING POOL OR <br />