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A SAN JOAQUIN COUNTY <br />`} D "RONMENTAL HEALTH DEPART—NT U� <br />6t.- cast Main Street, Stockton, CA 95202--j29 ZogJ <br />' <br />Telephone: 209 468-3420 Fax: 209 464-0138 Web: www.s ov.or hd <br />Bogy P ( ) � ) J9 9 <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: /p 16 <br />Address: a bs <br />City: Zip Code:' 1 3S3 7 (P <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: Inspection Type: <br />Y, 4P62b <br />Flow Rate (gpm): <br />pH: <br />Chlorine (ppm): <br />Cyanuric Acid (ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT:' <br />.. ,. <br />Th r d violations represent Health & SafetyCode Violati ns and must be corrected <br />dd}as indicated: <br />ElFilters... <br />�Qt N H —Vt4 <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />5i <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />uJ 9' a 0 <br />CONSTRUCTION_; <br />,/RN� - <br />L1 Pool Shell _ _ <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool -2 Main Drains <br />'ZA/ .,��,p,- <br />�7 k e4 -h1 '�'�-hf&'o✓G� d10 <br />/1vC, gw � /0,W. <br />4'C t.ULtT,t'y/ <br />SAFETY EQUIPMENT <br />❑ _Rescue Pole <br />Life Ring <br />El✓ <br />❑ Safety Signs <br />❑ Lifeguard <br />/rl, w�. <br />,, r• y (9� If a l� vlv- <br />D � s -4 <br />ElPool/Deck Lighting <br />❑ Ladders/Hand Rails <br />4�itawn <br />M)j <br />❑ Depth Markers/Tiles <br />IhD <br />-- <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />,..r�-//1-1,�, ;LOM <br />RESTROOMS <br />El Showers <br />❑ Toilet & Dressing <br />9- e <br />— <br />❑ Ventilation <br />_ _ 11AL1 TY <br />❑ Chlorine <br />,,J� ��jl <br />YIK. "VG �I.�Jiti <br />fKi.Wf <br />Mo <br />❑ PH <br />❑ Cyanuric Acid16 <br />ElClarity <br />❑ Test Kits <br />7 V" <br />L9 CdkfU 5wt('S <br />tP <br />MISCELLAN.EOU S <br />_❑ Super <br />❑ Gener I '/ 0 1- <br />o. <br />A --t <br />g <br />❑ AlgaeWWI <br />Influent: <br />Effluent: <br />Time In: Received _By: , <br />Time Out: /,��[�/J <br />Inspected by: <br />El 36-M 7-31-09 SWIMMING POOL OR Page Of L <br />