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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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EHD - Public
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iYYt"" <br />SAN JOAQUIN COUNTY <br />EN, IRCINMENTAL HEALTH DEPARTMENT <br />N <br />600 East Main Street, Stockton, CA 95202-3029 <br />:.. p. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />4GiF0PN <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Mii.' u)- .7 P, 177 1 7) Date: —/ d <br />Address: !J Yl, AT City: 4 p-� Zip Code: aj _a,6q� <br />Owner/Operator: r t Telephone: i' vT — ( / <br />i <br />Program Element: �(q / Program Recor . %t d Inspection Type: .1 <br />Flow Rate (gpm): pH: <br />Ch <br />'ne (ppm): <br />Cyanuric Acid (ppm):±Te <br />Reinspection on or after: <br />✓,� <br />RECIRCULATION EQUIPMENT <br />The marked violations re resent Health & Safety Code Violations and must be corrected as indicated: <br />❑ Filters <br />❑ Pumps <br />. Q gtK , <br />❑ Chlorinator <br />❑ Flowmeter <br />❑ Gauges <br />P`� //�� <br />l ' Tom- G{y. (X J 4. - <br />❑ Skimmer &Gutters <br />❑ Back Flow Prevention <br />- <br />❑ Main Drain Cover�vt <br />- t-f�'��ytA e, a <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />GzeaK1 1 <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />17 <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />❑ Rescue Pole <br />U�r - <br />❑ Life Ring <br />❑ Safety Signs <br />❑ Lifeguard <br />'44 f2q to , <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 />WATER QUALITY <br />❑ Chlorine <br />❑ pH <br />_ <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />_ <br />❑ General Sanitation <br />❑ Algae <br />th(• - q <br />w /`- <br />Influent: <br />Effluent <br />,17 'J'-4— <br />K,Time <br />Time ln: <br />`' <br />Ree ved By: <br />o <br />Inspected by: <br />Time Out: <br />EHD 36-0105-29-2007 <br />Page — of <br />ii <br />
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