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IJ <br />CPgUIry C <br />P: -1 <br />• C4l/co R''�P <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTNICNT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.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: /4A3l <br />A* SVG' <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 &Safe Code Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />a1 <br />❑ Chlorinator <br />❑ Flowmeter <br />A <br />❑ Gauges <br />a A <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />04",a. j/ nnL r <br />�l�t. /nl.fJ(.CG.0 <br />❑ Main Drain Cover <br />0.4V C DIL e <br />❑ Equalizer Line Cover <br />-- _CONSTRUCTION,.. <br />r/ _ <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />(� Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />%I <br />❑ Rescue Pole <br />� <br />E] Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />�f <br />(% e1Y, 3 h <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />d' <br />❑ Depth Markers/Tiles <br />Q <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />��-yJ� e <br />""'-- <br />RESTROOMS <br />❑ ShIDn <br />❑ Toilsing <br />❑ Ven i <br />w UALITY <br />_ 9A <br />Chlo e <br />p/rI�P <br />❑ PH <br />F1 Cyan _ <br />/� r <br />I__'c.M�- t") <br />F-1 Test <br />MISOrt=PEOUS <br />S� <br />❑ Supervision & Control <br />❑ General Sanitationa�+- <br />❑ Algae <br />Influent: <br />Effluent: <br />tr • .JL.C�c`-P <br />Time In: <br />Received By: Inspectedby: <br />Y <br />Time Out: <br />EHD 36-017-18-08 SWIMMING POOL OIR <br />