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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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EHD - Public
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ip <br />SAN JOAQUIN COUNTY <br />ENV )NMENTAL HEALTH DEPARTM.. 1"1868 East Hazelton Avenue, Stockton, CA 95205-'6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT, <br />Name of Facility: Date: ' <br />Address:/U. City: Zip Code: <br />Owner/Operator: 64[ Wli- Telephone: <br />Program Element: <br />Program Record: ( Inspection Type: r is� <br />Flow1 Rate (gpm): <br />pH: <br />Chlo a pm): <br />Q ,�- <br />AAcid (ppm): <br />Cyanu4ric Acid <br />l b <br />Temp: <br />Reinspection qn ora er: <br />CAR/[ <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />C toy ham- a 0 , rC - �Gt <br />❑ Pumps <br />(jt- d �/� I/�(�+7d V— <br />❑ Chlorinator <br />_ <br />❑ Flowmeter <br />E] <br />a1 6j Aj Q �Gi�� (� LU y I �e <br />❑ Gauges <br />17 N Et vv -e- <br />❑ Skimmer &Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />_ <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />Pool Shell <br />� '`_ <br />U C t�!/�z4 wvof--G 4V <br />_❑ <br />E]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 />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />REST:ROOMS <br />-- <br />- -- - <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />- -. WATER QUALITY. <br />Chlorine <br />_❑ <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />-' MISCELLANEOUS - <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: <br />Effluent, 11 <br />Time In: <br />Received By: <br />Inspected by: <br />Time Out: r�(,(``Qi(•- <br />EHD 36-015-8-12 SWIMMING POOL OIR Page — of <br />I <br />
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