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01/04/2010 14:25 9165671140 LESLIES POOL SUPPLY PAGE 02 <br />Iu09 'I Hu 3: Sb l•r 294683433 Sac EHo <br />INSTALLATION CERTIFICATION <br />VGB SAFETY VACUUM RELEASE SYSTEM (SVRS) S'UA�t(gt' <br />NOTE: Use one form for each pump. <br />For the property located at 1 <br />i r V_� y <br />'�JrStf <br />if <br />County, California, I hereby certify that p rsuant to Federal law: Virginia Graeme Baker <br />Pool & Spa Safety Act, that an SVRS meeting the current standards of the American Society of <br />Mechanical Engineers ASME/ANSI standard A 112.19.17 or ATSM F2387 has been installed per the <br />manufacturer's instructions on the: <br />Y Swimming Pool <br />c: Spa <br />c Wading/toddler pool <br />yI1/'I'I� <br />Existing Pump: Make/Model fte, i!/t�{ S— l�f� ; Flow(gpm)�_ <br />Manufacturer of approved SVRS:��tr <br />SVRS bears the following markings: <br />Model/Part Number: <br />n "ATSM F2387", <br />u "ASME/ANSI standard A 112.19.17" <br />I declare that I hold an active California State Contractors license #� , with the necessary <br />classifications; C-53, Swimming Pool Builder and/or C-610-35, Swimming Pool & Spa Maintenance & <br />Repair� <br />Si nat re Print namill Date <br />Public Law, 110.140 December 19, 2007 as Printed in the Federal Register <br />(r,) PUBLIC POOLS.— <br />(1) REQUIRED EQUIPMENT— <br />(U) each public pool and spa in the United States with a single main drain other than an <br />unblockable drain shall be equipped, at a minimum, with 1 or more of the following devices or <br />systems designed to prevent entrapment by pool or spa drains that meets the requirements of <br />subparagraph (9): <br />(I) SAFETY VACUUM RELEASE SYSTEM. --A safety vacuum release system <br />which ceases operation of the pump, reverses the circulation flow, or otherwise provides <br />a vacuum release at a suction outlet when a blockage is detected, that has been tested <br />by an independent third party and found to conform to ASME(ANSI standard A i 12.19 1 i <br />or ASTM standard F2387. <br />