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,QAa!?irr, SAN JOAQUIN COUNTY <br /> E RONMENTAL HEALTH DEPAR-, _NT <br /> '• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �FORa Telephone:(209) 468-3420 Fax: (209) 468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: t Date: 1 L <br /> Address: 2 'E , --r City: 1 Zip Code: <br /> Owner/Operator: t Y Telephone: <br /> Program Element: 3 ''� Program Record: (� Inspection Type: <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: O ` Reinspection on or after: <br /> 1J'r\�' �• C'C' 7,Lf /00 Other:0 1 if I <br /> f <br /> RECIRCULATION EQUIPMENT The arked violations represent Health& Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters PM <br /> ❑ Pumps r <br /> ❑ Chlorinator b t y <br /> 1111 1-2 <br /> lowmeter 1 <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover 1�6(A) Q i r <br /> CONSTRUCTION R F — <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates <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 /> I] Emergency Shut-off Switch <br /> RESTROOMS - <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> WATER QUALITY <br /> ❑ Chlorine <br /> ❑ PH - <br /> Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ Supervision & Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: 14 <br /> f 1 Time in: I Received By: I n s Exc to <br /> Effluent: 10 y�� -L <br /> rime Out: I ) 1 <br /> eo-w— <br /> EHD 36-01 5-8-12 SWIMMING POOL OIR Page A,of <br />