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SAN JOAQUIN COUNTY <br />B RONMENTAL HEALTH DEPART.. _:NT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />C,CI FOR�`P <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: City: Zip Code: Q <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: 'mq-, to <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 />❑ Pumps <br />_ S <br />❑ Chlorinator <br />❑ Flowmeter <br />' J <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />3 r o <br />3 <br />L] Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />1 61 <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />l.�K-�J r r , <br />- S V ']c <br />E] Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />„0� ,Q O <br />a -*4 <br />❑ Rescue Pole <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />`f K/ p(fLQ� _,A0 b <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />e <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />/1(Rli. B 2 <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />„ /„ 0 , <br />TI/� C� <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />a <br />AA .CGtcQ�� l/• vii <br />❑ pH <br />❑ Cyanuric Acid <br />O <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />Sq fmisioh tl <br />ral Sbn n <br />t <br />A _ ' , <br />y� <br />,�_ s 1` S <br />< <br />�eG J Yr 1V Will 111111' <br />Influent: <br />Effluent: <br />. _ Ain a 04!�,B 4 1d2 0 y <br />Time In: <br />Receive y: <br />v.�eA <br />ns acted by: <br />Time Out: <br />EHD 36-017-18-08 SWIMMING POOL OIR 1-01 <br />