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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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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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SAN JOAQUIN COUNTY <br />a � ENVIRONMENTAL HEALTH DEPARTIvi"NT <br />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: a dew <br />La <br />Date: W�-- <br />Address: <br />City:S�fr�Zip <br />Code: <br />Owner/Operator: Q <br />Telephone: <br />Program Element: <br />Program Record: <br />'Inspection Type: <br />vle - -- <br />Flow Rate (gpm): <br />pH: <br />y-� <br />0 <br />ChlorineCy]anurric <br />[(pJp <br />L k <br />D d-' (,C— <br />Aci ppm): <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />I <br />V <br />❑ Pumps <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />❑ Equalizer Line Cover <br />-_ CONSTRUCTION <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />- <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 />RESTROOMS: <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />- <br />WATER QUALITY <br />❑ Chlorine <br />❑ pH <br />— <br />_ - <br />- <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: I <br />`� <br />Effluent: 10 <br />Time In: <br />Time Out: <br />Received By: <br />Inspected by: _D <br />EHU 36-01 5-8-12 SWIMMING POOL OR / Page _of <br />
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