Laserfiche WebLink
;5AN JuAuU Ti t LjLfN I f <br />ENVIRONMENTAL -HEALTH DEPARTMENT <br />.: .�.. M <br />186rI East Hazelton Avenue, Stockton, CA 95205-623 <br />;Fa• Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.Si!gw.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: City: Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: D <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 />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />p� <br />I� Ain Ytt�n .- sa <br />❑ Pumpswb <br />1 <br />uy*'VA Wx Cd y keh ra t,.,• C.4 -I Shea•($ <br />❑ Chlorinator <br />❑ Flowmeter <br />I'm 16 (re- <br />[I Gauges q,�•( <br />Lu/t24 'VtfA- o <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />Ur 0 <br />E] Main Drain Cover <br />1 <br />+eLf <br />❑ Equalizer Line Cover <br />- CONST.RU.CTION_ <br />f1+ o <br />❑ Pool Shell <br />❑ Fencing/Gatest�fl1 <br />ty t�v—'t wnKriow <br />❑ Decking & Coping <br />❑ Wade Pool -2 Main DrainsJ'rjro• <br />SAFETY EQUIPMENT <br />❑ Rescue Pole <br />Cqauu <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />n <br />fAdk-,6 mac, Q •31 <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />A*h fie. <br />❑ Depth Markers/Tiles <br />dig 44-. y <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />I <br />❑ Showers <br />iadZJ/1 <br />❑ Toilet & Dressing <br />Z�[ ho <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />hAA h L <br />_ <br />❑ pH > <br />❑ Cyanuric Acid <br />'_ kilzt�_ ° <br />❑ Clarity <br />eL <br />❑ Test Kits fKb <br />_ - MISCELLANEOUS- <br />❑ Supervision & Control <br />Z� <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent: <br />Timeln: ', �-'a <br />Received By: <br />Vnsfted y: <br />33Time <br />.J <br />Out; <br />EHD 36-015-8-12 SWIMMING POOL OIR Page of --a-- <br />