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' 04/16/2009 THU 8:58 WD" '094683433 SJC 30D 00051/403 <br /> INSTALLATION CERTIFICATION <br /> VGB SAFETY VACUUM RELEASE SYSTEM (SVRS) <br /> NOTE: Use one form for each pump. <br /> r <br /> For the property located at V Mfr 0 — —' <br /> County, California I hereby certify that ursuant 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 ASMEIANSI standard A 112.19.17 or ATSM F2387 has been installed per the <br /> manufacturer's instructions on the: <br /> Swimming Pool <br /> n Spa <br /> o Wading/toddler pool <br /> Existing Pump: Make/Model ; Flow(gpm)— <br /> Manufacturer of approved SVRS <br /> SVRS bears the following markings: <br /> Model/Part Number: ;f-5 DO <br /> ❑ "ATSM F2387", <br /> r� "ASME/ANSI standard A112,19.17", <br /> I declare that I hold an active California State Contractors license# , with the necessarl' <br /> classifications; C-53,Swimming Pool Builder and/or C-61/13-35, Swimming Pool&Spa Maintenance& <br /> Repair. <br /> bD r, F <br /> Sq <br /> atur L Print ria a Date <br /> Public Law: 110-140 December 19, 2007 as Printed in the Federal Registor <br /> (c) PUBLIC POOLS.— <br /> (1) REQUIRED EQUIPMENT.— <br /> (1i) each public pool and spa in the United States with a single main drain other than an <br /> unblockable drain shag 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 (B): <br /> (1) 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 ASMEIANSI standard A112.19.17 <br /> orASTM standard F2387. <br /> 1 a �} <br /> o431 F�i e B*ate <br />