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Time In: 10.00 am <br />Time Out: 10:30 am <br />a�,AHlN, San Joaquin County <br />a �'•.o <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.oro/ehd <br />•.�4Y11s6ANvp <br />Swimming Pool Official Inspection Report <br />Name of Facility: SHADOW LAKE MOBILE HOME PARK LLC <br />Date: 07/14/2016 <br />Address: 5100 N HWY 99, STOCKTON 95212 <br />Owner/Operator: SHADOW LAKE MOBILE HM PRK LLC <br />Telephone: (707) 864-0269 <br />Program Element: 3612 - PUBLIC POOL/SPA -ADDITIONAL <br />Inspection Type: INSPECTION/REINSPECTION 1 hr minimum <br />VIOLATIONS AND CORRECTIVE ACTIONS <br />Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code section(s) 116043, 116040, 8 <br />116050. All violations must be corrected within specified timeframe. Violations that are classified as "MAJOR"pose an immediate threat to public health <br />and must be corrected immediately or be subject to closure pursuant to California Code o/ Regulations (Title 22) section 55545. <br />OVERALL INSPECTION NOTES AND COMMENTS <br />OBSERVATIONS <br />Flow rate: gpm Chlorine: 4.2 <br />Cyanuric acid: ppm pH: 7.2 <br />NOTES <br />Violations corrected. Copy of report emailed to shadowlakemhp@live.com <br />eF <br />Combined chlorine: ppm <br />The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br />Safety Code. If a reinspection is required, fees will be assessed at the current hourly rate. <br />Received by: <br />EH Specialist: <br />"+% .,— <br />Name and Title <br />JEFFREY WONG Phone: <br />Bruce Gale, maintenance <br />468-0335 <br />FA0002794 PROM0256 SC333 OWW2016 <br />EHO 3601 Rev. 06/30/15 Page 1 of 1 SMrnming Pool OIR <br />