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oP4��N. SAN JOAQUIN COUNTY <br /> ENVi. ,ONMENTAL HEALTH DEPARTML.nT <br /> ;'• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> q�.FOR�a� <br /> Telephone:(209) 468-3420 Fax:(209) 468-3877 Web:www.sjgov.org/ehd <br /> SWIMMING POOL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ii Date: 7 <br /> Address: S S !��r I c, n City: Zip Code: Cf S S S' <br /> Owner/Operator: LG .� jou)c ) L r Telephone: <br /> Program Element. JI /�/1 Program Record: -5 2 :n j S S 2 3,6 Inspection Type: �4 1 .-)e <br /> Flow Rate(gpm): pH: Chlorine(ppm): Cyanuric Acid(ppm): Temp: Reinspection on or after: <br /> Other: <br /> R'ECt�t Ut:ATtOtJ EQtJ1t?NlENT i The marked violations represent Health&Safety Code Violations and must be corrected as indicated: <br /> ❑ Filters p d <br /> ❑ Pumps <br /> ❑ Chlorinator —tree C h 1 d r; n( q C)• /Y) <br /> ❑ Flowmeter re <br /> ❑ Gauges <br /> ❑ Skimmer&Gutters <br /> ❑ Back Flow Prevention <br /> ❑ Main Drain Cover <br /> ❑ Equalizer Line Cover 'r p C 0 r r <br /> , gl+iaTRUCTt, <br /> ❑ Pool Shell r P 0p e n <br /> ❑ Fencing/Gates <br /> ❑ Decking&Coping <br /> ❑ Wade Pool—2 Main Drainsn ��r & as e C <br /> liP <br /> ❑ Rescue Pole <br /> ❑ Life Ring <br /> ❑ Safety Signs S <br /> ❑ Lifeguard r Q ' rl c' i G �) C r <br /> ❑ Pool/Deck Lighting W p p )'?5. <br /> ❑ Ladders/Hand Rails <br /> ❑ Depth Markers/Tiles <br /> ❑ First Aid Kits <br /> ❑ Emergency Shut-off Switch <br /> ❑ Showers <br /> ❑ Toilet& Dressing <br /> ❑ Ventilation <br /> i A <br /> Ej <br /> Chlorine <br /> ❑ pH <br /> ❑ Cyanuric Acid <br /> ❑ Clarity <br /> ❑ Test Kits <br /> Wi'aC 1:1 AtfEOUS <br /> ❑ Supervision&Control <br /> ❑ General Sanitation <br /> ❑ Algae <br /> Influent: <br /> Recei e - MIP <br /> cted by: <br /> Time In: 3 2 <br /> Effluent: <br /> Time Out: I S S <br /> EHD 36-01 5-8-12 SWIMMING POOL OIR Page of <br />