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Ns I- Pgg1N SAN JOAQUIN COUNTY r y ?� ENVIR NMENTAL HEALTH DEPARTMEIN f 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd Q�IFO RN\ SWIMMING POOL OFFICIAL INSPECTION REPORT Name of Facility:o 5 Date: e) - / - O Address:9 0 ity: C Zip Code: Owner/Operator: [„y Telephone: q Program Element: Program Record: Inspection Type: PL� -yyl C1!e Flow Rate (gpm): pH: Chlorine (ppm): Cyanuric Acid (ppm): Temp: Reinspection on or after: Other: RECIRCULATION EQUIPMENT The marked violations represent Health& Safety Code Violations and must be corrected as indicated: ❑ Filters / _ 36a�c El Pumps CC = G O, c �o O ❑ Chlorinator ❑ Flowmeter ❑ Gauges ❑ Skimmer & Gutters ❑ Back Flow Prevention ❑ Main Drain Cover / - �".� C ❑ Equalizer Line Cover CONSTRUCTION ❑ Pool Shell ❑ Fencing/Gates ❑ Decking & Coping ❑ Wade Pool - 2 Main Drains SAFETY EQUIPMENT ❑ Rescue Pole ❑ Life Ring ❑ Safety Signs ❑ Lifeguard ❑ Pool/Deck Lighting ❑ Ladders/Hand Rails _ 2 3 ❑ Depth Markers/Tiles r - 4, fl zz-0 C & v 00 f - ❑ First Aid Kits ❑ Emergency Shut-off Switch - RESTROOMS ❑ Showers ❑ Toilet & Dressing ❑ Ventilation �• ' _ 'apan _S WATER QUA LFI ❑ Chlorine ❑ pH ❑ Cyanuric. Acid ,bLJ r _ — J00pgin - i--5 O ' M _ -4 146 ❑ Clarity El Test Kits MISCELLANEOUS ❑ Supervision & Control Af s `J •Q/Yli " -1�- E] General Sanitation ❑ Algae Influent: Effluent: Time eceived By: Io a ed by: Time Ou EHD 36-015126/05 �— V Page — of