Laserfiche WebLink
//,L/ E7 Address <br />Site address of pool(s) /1/4 <br />City ////tAIMA el/ / <br />Number of swimming pools, spa pools, wading pools or special purpose pools at the site <br />I verify that I am the owner/home owner association president/legally responsible person for the <br />above named pool(s) and that I had the pool(s) inspected for compliance with Section 116049.1 <br />(a-f) of the California Health and Safety Code. <br />DR/_ M Eu-i flare C -99 Print name <br />Signature <br />City YFJECJ St C—A Zip 7 <br />Telephone ( 2z9 13 - <br />fl There is no pool light in this/these pool(s). Indicating there is no pool light means there <br />is no light fixture, light casing, or recessed light niche, whether working or not <br />working, within the confines of the pool shell. <br />PUBLIC ELL:Ai:EH SERVIMES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />Karen Furst, M.D., M.P.H., Health Officer <br />304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br />209/468-3420 <br />VERIFICATION OF COMPLIANCE WITH CALIFORNIA HEALTH AND <br />SAFETY CODE, SECTION 116049.1 (a-f) <br />Please attach a copy of the completed and signed inspection permit or report from the local <br />building department or the qualified contractor and send to: <br />San Joaquin County <br />Public Health Services <br />Environmental Health Division <br />Recreational Health Program <br />304 East Weber Avenue, Third Floor <br />Stockton, CA 95202 <br />f"- .r'-1 <br />;ur <br /><1 <br />bo4` <br />A Div;sion or San foaqual County Health Care Services