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V.1, SAN JOAQUIN COUNTY EI RON MENTAL HEALTH DEPAR-i :NT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd SWIMMING POOL OFFICIAL INSPECTION REPORT Name of Facility: Date: -?[/:L/ /d Address: City: Zip Code: Owner/Operator: 51 1 Telephone: Program Element: Program Record: Inspection Type: I/ 9r- *&16d0 Flow Rate (gpm): pH: Chlorine (ppm): Cyanuric Acid (ppm): Temp: Reinspection on or after: Other: ..RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must be corrected as indicated: ❑ Filters _ _ ❑ Pumps �' S S`o� ❑ Chlorinator ❑ Flowmeter G1/LAu� — GGA^ ❑ Gauges ❑ Skimmer & Gutters ❑ Back Flow Prevention ❑ Main Drain Cover ❑ Equalizer Line Cover CONSTRUCTION - o ❑ Pool Shell ❑ Fencing/Gates l U VA ,1 JV ❑ Decking & Coping ❑ Wade Pool - 2 Main Drains SAFETY EQUIPMENT ❑ Rescue Pole ❑ Life Ring ❑ Safety Signs O a ❑ Lifeguard ❑ Pool/Deck Lighting ❑ Ladders/Hand Rails I IF ❑ Depth Markers/Tiles �n / d ❑ First Aid Kits ❑ Emergency Shut-off Switch RESTROOMS ❑ Showers ❑ Toilet & Dressing ❑ Ventilation WATER QUALITY ❑ Chlorine - ❑ pH _❑ Cyanuric Acid ❑ Clarity ❑ Test Kits - MISCELLANEOUS = �. ' /- ❑ Supervision Control _& ❑ General Sanitation ❑ Algae. Influent: Effluent: Time In; Rece'ved By: Time Out: I I spec[ EHD 36-01 7-31-09 SWIMMING POOL OIR Page Of /