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a�ln. SAN JOAQUIN COUNTY <br />r' 1 E, 'RONMENTAL HEALTH DEPART ENT <br />1868 cast Hazelton Avenue, Stockton, CA 95205-6232 <br />1Ro' <br />" Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: LG 11' 4 , L / 6/ Date: 7-/ y . / <br />Address: .7 y 1 o c, P e kcI City: -"r 0 C Zip Code: <br />Owner/Operator: bj 1005ror G 140 <br />1,6 j Telephone: <br />Program Element: ,j ( Program Record: Is R&'3)SInspection Type: co I; <br />Flow Rate (gpm): <br />I <br />%J <br />t V Til <br />pH: <br />7. 2 <br />Chlorine (ppm): <br />R • �.2 • �.b <br />Cyanuric Acid (ppm): <br />A1I D <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & SafetCode Violations and must be corrected as indicated: <br />❑ Fillers <br />,l Com b ned Ghjor.na of O.6 12 0 41 <br />❑ Pumps <br />11 <br />%%� (A ; y� ?U Y1 G n �Ur r%6 A <br />❑ Chlorinator <br />❑ Flowmeter <br />r e S S i h a • N r+1 C <br />❑ Gauges <br />C ; <br />f r., n ryp <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />3 erS J 1c, cK In 2 i el <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />aCRiJC770' <br />E] Pool Shell <br />�J) pp 1 <br />K t I SP 0; a rr h P ct s n C e V S <br />❑ Fencing/Gates <br />Q yt e X i P r i o r O Jo or • C G rr e d <br />❑ Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />we e K. <br />SAFETY'. EQUIPMENT '" <br />S' , I loose- T Fti 4o,\ G <br />❑ Rescue Pole <br />row, I ; w e e K <br />❑ Life Ring <br />❑ Safety Signs <br />6 r i- IG f/ <br />/Qy� / I Qn U <br />El Lifeguard <br />P r✓I I Rea r W O <br />ElPool/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 />- — <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: ) <br />/ <br />Effluent <br />Time In: <br />a ived y: <br />I sp ct d by <br />�Y <br />Time Out: Z <br />L -I I r <br />EHD 36-01 5-8-12 SWIMMING POOL OIR Page I of <br />