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Owner/Operator:
<br />Name of Facility:
<br />Address:
<br />Date: iffo,s-hi
<br />Zip Code: qT3 70
<br />Telephone:
<br />Th, tya City: 74c4x
<br />Inspection Type: Program Record: Program Element:
<br />Flow Rate (gpm): Chlorine (ppm): Cyanuric Acid (ppm): Temp:
<br />Other:
<br />Reinspection on or after: pH:
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<br />ted by:
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<br />Received By:
<br />Time Out: ()L-t-f> c(
<br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated:
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<br />Page/ of
<br />Time In:
<br />-sci:ft,331
<br />. fyit p/ 71 0?-9-Q__ lie&„
<br />MI Filters
<br />Pumps
<br />Chlorinator
<br />Flowmeter
<br />Gauges
<br />Skimmer & Gutters
<br />IN Back Flow Prevention
<br />MI Main Drain Cover
<br />Equalizer Line Cover
<br />CONSTRUCTION
<br />Pool Shell
<br />M Fencing/Gates
<br />Decking & Coping
<br />Wade Pool — 2 Main Drains
<br />SAFETY EQUIPMENT
<br />Rescue Pole
<br />Life Ring
<br />Safety Signs
<br />Lifeguard
<br />Pool/Deck Lighting
<br />M Ladders/Hand Rails
<br />M Depth Markers/Tiles
<br />IN First Aid Kits
<br />Emergency Shut-off Switch
<br />Showers
<br />Toilet & Dressing
<br />M Ventilation
<br />WATER QUALITY
<br />Chlorine
<br />pH
<br />M Cyanuric Acid
<br />Clarity
<br />Test Kits
<br />!MSC N OS
<br />II Supentsion.& ntrol
<br />IN Geneial Sanitation
<br />IN Algae .C-,
<br />Influ
<br />Effluent:
<br />EHD 36-01 7-31-09 SWIMMING POOL OR
<br />SAN JOAQUIN COUNTY
<br />E. ,RONMENTAL HEALTH DEPAM LENT
<br />600 East Main Street, Stockton, CA 95202-3029
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd
<br />SWIMMING POOL OFFICIAL INSPECTION REPORT
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