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Ixln. SAN JOAQUIN COUNTY <br /> ,:ter•., <br /> ENVIRvNMENTAL HEALTH DEPARTMEK-, <br /> -- 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> - ' Telephone:(209) 468-3420 Fax: (209)468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: ra r�- <br /> Owner/Operator: Telephone: UPJ <br /> Program Element: Program Record: -5-0 r4r Inspection Type: - - <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: <br /> RECIRCULATION EQUIPMENT The marked violations represent Health&Safety Code Violations and must be corrected/as indicated: <br /> ❑ Filters — heb" asw are ✓KOw?3 <br /> ❑ Pumps <br /> ❑ Chlorinator tx <br /> ❑ Flowmeter JJ <br /> ❑ Gauges in�D C W H <br /> ❑ Skimmer&Gutters q.. SA e- '500--YV� l . 2- <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover �K <br /> CONSTRUCTION _ <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates I �an1 I1'1 t ver-, ry <br /> ❑ Decking&Coping �� / NQ. <br /> ❑ Wade Pool-2 Main Drains LLN d0 <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck lighting Tk�rr�wp v11"14211- big cove- •b r�o <br /> ❑ Ladders/Hand Rails Qn t.01-- 4112— <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits l I KlsS M'.L t! ti <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS CmLee�sV✓L <br /> ❑ Showers <br /> ❑ Toilet&Dressing <br /> ❑ Ventilation <br /> ❑ Chlorine 1 , _ <br /> EI pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ Supervision&Control � <br /> E] ^General Sanitation �or~ u %� - rdYt Vr wu.. C <br /> kj <br /> ❑ Algae <br /> Influent: <br /> Time ln: Received By: In ted b <br /> Effluent: Time Out: <br /> EHD 38-01 5-8-12 SWIMMING POOL OIR Page—of <br />