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SAN JOAQUIN COUNTY <br />e <br />EN..RONMENTAL HEALTH DEPART. .IST <br />< 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: City: Zip Code:' <br />OwnerlOperator: Telephone: <br />Program Element: Program Record: Inspection Type: )48/020 <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after. <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONST.RU.CTI ON <br />❑ Pool Shell <br />❑ Fencing/Gatesi <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 />❑ ClaritV <br />❑ Test t 4 s <br />n <br />❑ Supervision & Control <br />ee <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Time In: <br />Reiv y <br />rinspe ted by: <br />v41 ,vJ71.F <br />Time Out: <br />EHO 36-017-31-09 SWIMMING POOL OR <br />Page —(— of <br />