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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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SAN JOAQUIN COUNTY <br />ENb IRONMENTAL HEALTH DEPARTML" NT <br />- 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />c.._. P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />gCiFSPH <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: Date:W �p <br />Address: City: Zip Code: <br />Owner/Operator: Telephone: 4.?7I <br />Program Element: Program Reco : Inspection Type: <br />Flow Rate (gpm): <br />I <br />pH: .7, rN <br />`f, <br />Chlorine (ppm): <br />0 lv t r Qfo <br />Cyanuric Acid (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 />�e_ _ •L Q I+ ` AJ��a�'�-�ilY�` . <br />❑ Pumps12 <br />1 n aa <br />4-a <br />E] Chlorinator <br />Flowmete <br />Ll _l <br />�t�( <br />Gauges <br />st /L�� lAA41 7 [�' <br />, <br />Skimmer &Gutters <br />❑ Back Flow Prevention <br />t „ •p <br />-�('� <br />❑ Main Drain Cover <br />t <br />❑ Equalizer Line Cover <br />CONSTRUCTION <br />3 • � <br />❑ Pool Shell <br />❑ Fencing/Gates <br />❑ Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />/.n <br />to mu&&L �TJ�'� CX2,fLt� <br />❑ Rescue Pole <br />Z • t <br />❑ Life Ring <br />❑ Safety SignsQ- <br />N <br />o t, <br />E] Lifeguard <br />, <br />/' S <br />❑ PooUDeck Lighting <br />❑ Ladders/HandRails <br />�//� <br />D :37 00 G _ _ ✓/ _ <br />E] Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />_—IH <br />J.dJLfGl�� <br />RESTROOMSLA <br />I <br />C <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 />\ <br />❑ General Sanitation <br />❑ Algae <br />• 1 r"i F� <br />Influent: �� ��� <br />Effluent: � p�r <br />,1�1n •, <br />Time AM <br />S <br />Receiv <br />Inspected b <br />Time Out: <br />Out: )v <br />EHD 36-01 5/26/05 Page of <br />
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