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San Joaquin Local Health District 1) Stockton: California <br />Public Swimming Pool Evaluation Series <br />General Information Sheet <br />V11^1...1,34...sdkma.1.1311Masell,A....,..anos.”21.1•Cf. <br /> <br />.cu,r4 • 0, 'I ANT SI,. <br /> <br />Name and and Address of Establishment Operator <br />....aTicasICAISLQw Type o' Pool <br />H (305-E <br />Special(t1 -5 SwimminP Wadinc, <br />TME-6=0;57r: A.dress <br />QC, <br />pcD _6-R7 Owneri 1TGT <br />...,..LtaUsaitsLAL0 <br />INSTRUCTIONS: Fill out 2 cooies. <br /> <br />Pool owner or contractor <br />4.3073202,1.1 <br />Building Inspection Department Health Department <br />• <br />Address Phone <br />DhSIGI7 Snallow End <br />Depth <br />Ft. In. <br />Pool Shape Pool Dimensions Pool Surface Area Capacity <br />Sq, Ft. <br />15-0 x 5---Ft. Lig -.5-0 0 <br />Deep End Break Point Dist. Materials <br />Depth from Shallow Wall <br />Ft. in. Ft. In, <br />j—airfizi( 1,3 1( 'Az <br />Totai Area iu.n(L Turnover <br />O (-iv 1 RL LT 3i- <br />:2 517- -‘3,5 73.0 8 Hrs,..„_1:77TOtter <br />H.P. Discharge Dia: 0 gene Vic c— <br />Surface Di: Amu° (ft or psi) Nadel#T7J4 <br />Yes Height MISCELLANEOUS(Heater Slurry <br />DIVING BOARD EQUIPMENT <br />No ...grame4oLczekerommvaurmaseersecrera.,a-xerciara,rammsla.sawnwcznegauarat.asa: <br />ug.....1•3[1—• <br />FILTRATION <br />1111115r-MMICENa.• <br />PUMP <br />Application Submitted By: Lj J„_a ou..m..4 Date <br />Plans Approved By: Date <br />Inspection Required by the Health District: Contractor shall notify Health District at <br />747-5t77.4 hours'in'advance dr inspeZEME7-- <br />1. Final completion of pool. <br />By: <br /> <br />Date <br /> <br />NOTE: Approval of plans by this department may not be construed as a guarantee of any <br />equipment or installation. Prior to construction: a building permit shall be <br />obained from the County or local -Ouilding department.