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Pa�In, SAN JOAQUIN COUNTY <br />EN' ONMENTAL HEALTH DEPARTh ,T <br />• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />yFo>a Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />MMMING POOL OFFICIAL INSPECTION REPORT 5-f?51— <br />Name of Facility: d A All Date: <br />Address: 5 . City: Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Z, Progra Record: Inspection Type: <br />Flow Rate): <br />pH: 7 <br />Chlt(Iorine (ppm): <br />. D C C <br />Cyanc Acid (ppm): <br />J <br />Temp: C) / <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & SafetyCode Violations and must be corrected as indicated: <br />❑ Filters <br />; / ✓4ti 7N2� l (M C <br />El PUMPS <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <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 />❑ 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: 11 1 t <br />1 <br />Effluent: ( <br />Time In: � � L'� <br />Receive By: <br />n pe ted by: <br />/ <br />6 �(/cJ✓ Cl <br />Time Out: ' DS'oa <br />EHD 36-015-8-12 SWIMMING POOL OIR Pagel of „1 <br />