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r.gfa.... SAN JOAQUIN COUNTY <br />.o <br />& -30NMENTAL HEALTH DEPART NT <br />1868 East Hazelton Avenue, Stockton, CA 952uo-6232 <br />Telephone: 209 468-3420 Fax: 209 468-3877 Web: www.s ov.or /ehd <br />ikoti� P ( ) I ) 19 9 <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Xi y'% a ,(rj Date: 7 �b <br />Address: 1 k) w,ty"( City: Zip Code: <br />Owner/Operator: 4Telephone: <br />Program Element: '3afl Program Recor . v 3& L774- Inspection Type: k"e <br />Flow Rat pm): <br />If V <br />pH: <br />-16. <br />Chlprine (p�G ): <br />(� <br />a CL <br />Cyanuric (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 />1� <br />rJ 1 <br />❑ Pumps <br />QVLQ <br />E] Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />q� <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool — 2 Main Drains <br />n . - <br />Ci .�t.•� <br />SAFETY EQUIPMENT <br />n <br />❑ Rescue Pole <br />❑ Life Ring <br />VC <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails(fir <br />E] Depth MarkerslTiles <br />►rc-uJ <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />' <br />14 A (d LULCIL <br />RESTROOMS <br />/�{yt 1 0(ew --.wzW <br />❑ Showers _ <br />El Toilet &Dressing <br />❑ Ventilation <br />4- , d� — <br />—,04-6,4d <br />-�Cn v` - �A <br />L <br />WATER QUALITY <br />❑ Chlorine _ <br />,` w ^ ,r ` <br />kVd <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />la( <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: Ci <br />b <br />Effluent: <br />Time In: l `.0v <br />�R(ec 'ved <br />In ected by: <br />Time Out: <br />EHD 36-01 5-8-12 SWIMMING POOL OIR <br />6 <br />Page — of <br />