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op4�IN SAN JOAQUIN COUNTY <br /> ENviRONMENTAL HEALTH DEPARTN.cNT <br /> N;• C <br /> • 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: neo' (( =95 Date: ; <br /> Address: City: Zip Cod 9 <br /> Owner/Operator: elephone:PQ 3 X_ O <br /> Program Element: Program Record: Inspection Type: t <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reirispection on or after: <br /> Other: <br /> RECIRCULATION EQUIPMENT The marked violations re resent Health &Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters <br /> ❑ Pumps <br /> ❑ Chlorinator yk <br /> ❑ Flowmeter l <br /> of V V VV <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters $ '� <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Coverj�/�D� <br /> CONSTRUCTION <br /> ❑ Pool Shell <br /> ❑ Fencing/Gates owj <br /> ❑ Decking&Coping <br /> ❑ Wade Pool—2 Main Drains Sbg _ <br /> SAFETY EQUIPMENT <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard <br /> ❑ Pool/Deck Lighting <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> RESTROOMS <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> -WATER QUALITY <br /> ❑ Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> MISCELLANEOUS <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: I <br /> Time In: Received B i> Z7 re ed by: <br /> Effluent: Time Out: r /1 �j 3 <br /> EHD 36-01 5-8-12 SWIMMING POOL OR Page 4 of <br />