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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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n. SAN .JOAQUIN COUNTY <br />ENS _ .ONMENTAL HEALTH DEPARTh. IT <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 <br />Name of Facility: <br />ma <br />.�So ate: <br />- - <br />Address: <br />I69 City: <br />Zip Code: <br />Owner/Operator. .5IUtZ <br />3 9fi-- <br />Telephone: <br />3 �- CfAD D l <br />Program Element: 3 (�i( Program Record: R GL3/op��- <br />Inspection Type: , <br />Flow Rate (gpm): <br />6015+- <br />pH: <br />V4$ <br />Chlorine (ppm): <br />Jj , O �� <br />GL <br />Cyanuric Acid (ppm): <br />Temp: <br />Rei spection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & SafetCode Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />❑ Chlorinator <br />OD I <br />❑ Flowmeter <br />I L U 0 <br />Y <br />❑ Gauges <br />r i <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 />>41p <br />6> 1S <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />L1.. t.- <br />❑ Rescue Pole <br />YY <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 />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />WATER QUALITY <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />r <br />MISCELLANEOUS <br />❑ Supervisior & Control <br />❑ General Sanitation <br />❑ Algae <br />Influent: �a0 <br />^b <br />Effluent: w <br />Time ln: I; (J Received <br />Time Out: a; D i - <br />By: <br />Inspected by: I_� <br />t7R�(� {- & r"wJ kXA <br />EHG 36-01 7-31-09 SWIMMING POOL OIR Page I of l <br />=�2 <br />
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