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Pa.. „.. SAN JOAQUIN COUNTY <br />ENVIK. NMENTAL HEALTH DEPARTME:: <br />w` 600 East Main Street, Stockton, CA 95202-3029 <br />e;Fo a' Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />aj <br />Date: <br />—OU <br />Address: <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Agm <br />Program Element: 3 Program Record: U <br />Inspection Type: <br />Flow Rate (gpm): <br />90 <br />pH: <br />7. Y <br />Chlodne (pp <br />'0 <br />Cyanuric Acid (ppm): <br />C/t <br />Temp: <br />Reinspedio on or after. <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violatloU represent Health & Safety <br />Code Violations and must be corrected as indicated: <br />❑ Filters <br />- <br />[--]Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />00, <br />"Ir <br />40 <br />❑ Gauges <br />Z <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />all&i/ <br />❑ Decking & Coping <br />- a -- <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 Markersrriles <br />0.. <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />06 <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />'pyo <br />WATER QUALIT__ <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />p,- MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Time In: a r <br />i <br />Rece' ed y: <br />Ins <br />ted b <br />�� <br />Time Out• ° <br />v <br />EHD 36-017-31-09 SWIMMING POOL OIR Page _ of <br />