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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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5100
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1600 - Food Program
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PR0360256
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 1:55:56 PM
Creation date
6/10/2021 1:52:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0360256
PE
3612
FACILITY_ID
FA0002794
FACILITY_NAME
SHADOW LAKE MOBILE HOME PARK LLC
STREET_NUMBER
5100
Direction
N
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95212
APN
08704014
CURRENT_STATUS
01
SITE_LOCATION
5100 N HWY 99
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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P; Y.Iry• SAN JOAQUIN COUNTY <br />ENVIF IMENTAL HEALTH DEPARTMEI <br />•: 1868 East rlazelton Avenue, Stockton, CA 95205-o_d2 <br />" Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: iq <br />ix <br />d <br />y y w <br />Date: (,Q <br />Address: l <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: 0 <br />Flow Rate (gpm): pH: Chloe Upk <br />u -8s 7 d 1 �` <br />Cyanuric Acid (ppm): <br />0 V <br />Inspection Type: (V\ <br />Temp: Rei spection on or after: <br />Other. <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety <br />Code Violations and must be corrected as indicated: <br />[I Filters — <br />❑ Pumps <br />I r l IJ <br />f <br />l%t <br />el /(/' Z(/l- , <br />( <br />YYt <br />Chlorinator <br />❑ Flowmeter <br />eu <br />❑ Gauges <br />' /r <br />❑ Skimmer &Gutters <br />❑ Back Flow Prevention <br />rra <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />-- <br />— <br />-- <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool — 2 Main Drains <br />SAFETY EQUIPMENT <br />❑ Rescue Pole <br />— <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />❑ Ladders/Hand Rails <br />❑ Depth Markers[Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />--.:RESTROOMS <br />— <br />- <br />- <br />- <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <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 />Timeln:fIV <br />Received By: <br />x j� `V <br />Inspected by: <br />!� ' WU <br />Time Out: <br />EHD 36-01 5-8-12 SWIMMING POOL OIR Page — of <br />
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