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ow4�IN. SAN JOAQUIN COUNTY <br /> y' L ✓IRONMENTAL HEALTH DEPAF. IENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �4� FOgaP Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: `Z <br /> Address: PNcity: Zip Code: , <br /> Owner/Operator: Telephon IW7- 3(,..OD <br /> Program Element: Program Record: d Inspection Type: � '�- <br /> Flow Rate((gpm): pH: Q 'hlorinee ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> so �� Q.�(y ;PC-c Other: <br /> RECI.FCUL?AtsThe marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters .e L' ' � a U'0, Powa <br /> ❑ Pumps <br /> ❑ Chlorinator ( S A' <br /> ❑ Flowmeter <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters 2, 1 K' 40- 7.V 7 <br /> ❑ Back Flow Prevention �r <br /> El � L/S �LL <br /> Main Drain Cover y� " <br /> El Equalizer Line Cover AA 7� <br /> 6.4 / , <br /> ❑ Pool Shell H/ <br /> ❑ Fencing/Gates <br /> 44w'I't-i N" <br /> v <br /> ❑ Decking&Coping � _ <br /> ❑ Wade Pool-2 Main Drains ! Y <br /> ❑ Rescue Pole o /•'' <br /> ❑ Life Ring <br /> ❑ Safety Signs <br /> ❑ Lifeguard /J _ <br /> ❑ Pool/Deck Lighting 7/13//• �K <br /> ❑ Ladders/Hand RailsCjd <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> /Jr <br /> 4 <br /> ElShowers en <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> ❑ Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity ft <br /> El Test Kits aj <br /> draz�( S <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: I ` 3�JA! <br /> Time In: <br /> �) \ ;�� Received By: nape ted by: <br /> Effluent: <br /> t' 1 ✓ Time Out: <br /> C- <br /> EHD 36-017-31-09 SWIMMING POOL OR Page 4-of <br />