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0 Il l," <br />• SAN JOAQUIN COUNTY <br />ENVilcONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: City: ' ', Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Program Record: Inspection Type: <br />Flow Rate (gpm): pH: Chlorine (ppm): Cyanuric Acid (ppm): Temp: Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />• Filters <br />• Pumps <br />• Chlorinator <br />• Flowmeter -1-. ) r • <br />• Gauges <br />i i , ..,-) ..4.• • Skimmer & Gutters <br />• Back Flow Prevention <br />/--1 ..........._ • Main Drain Cover <br />1 i) -) :4 ,, ( - _ i -k-1N (aTtiA_Ay} <br />1 Equalizer Line Cover <br />CONSTRUCTION I <br />‘1‘44.14-1C : , ,.- A • Pool Shell <br />f I <br />• Fencing/Gates <br />• Decking & Coping <br />• Wade Pool —2 Main Drains <br />SAFETY EQUIPMENT <br />• Rescue Pole <br />IV x j v'- . iV, .; iXt) . Life Ring <br />V1e liA A , vtA ti t.,14 u', <br />'..) <br />I . Safety Signs <br />II Lifeguard U <br /> <br />. , --) ,- -T <br /> <br />^, ' <br />_ ,e , „ ..1 ..-Ne-,- • 1. ' -- 1 , A..a...c —_ ...._ • Pool/Deck Lighting <br />• Ladders/Hand Rails _ <br />J . Depth Markers/Tiles ,L.4.----1---4) <br />• First Aid Kits 4_ <br />• Emergency Shut-off Switch -‘) r <br />RESTROOMS <br />• Showers <br />• Toilet & Dressing <br />') ' - '-'s• ti',...c7,--v '1 , \--.1_ I/., t-1 M Ventilation <br />I t <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: <br />Effluent: <br />Time In: Received By: Inspected by: <br />Time Out: — <br />EHT) 36-01 5/26/05 <br />Page