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Facility Name: <br />San Joaquin County <br />Environmental Health Department <br />600 East Main Street <br />Stockton, California 95202-3029 <br />Website: www.sigov.org/ehd <br />Phone: (209) 468-3420 <br />Fax: (209) 464-0138 <br />epez-V. v\r"....%, <br />DIRECTOR <br />Donna Heran, RENS <br />ASSISTANT DIRECTOR <br />Laurie Cotulla, REHS <br />PROGRAM COORDINATORS <br />Carl Borgman, REHS <br />Mike Huggins, REHS, RDI <br />Margaret Lagorio, REHS <br />Robert McClellon, REF'S <br />Jeff Carruesco, REHS, RDI <br />Kasey Foley, REHS <br />Facility Address: jCI q ok. <br />Owner Name: Scxx. 4 <br /> <br />Authorized Representative: kv-'5N F\\ poc:1 4-60\ <br /> <br />IN;VN %srrdte.-.5 c am the owner or authorized <br />representative of the swimming pool and or spa at the above mentioned location. I <br />am providing the San Joaquin County Environmental Health Department (EHD) <br />with this notice of my intent to: <br />Provide a plug for the equalizer line(s) with a flush wall mount fitting. I <br />understand that by sealing the equalizer line, damage may occur to the pump <br />if the water level of the pool/spa falls below the skimmer level. At the time <br />of resurfacing, the plug will be removed and the approved suction cover(s) <br />will be installed over the equalizer line. <br />0 Close the pool until the approved suction cover is installed over the <br />equalizer line. I agree to call EHD for a clearance inspection prior to re- <br />opening the pool/spa. <br />Reason for not installing approved equalizer line covers: C06-7- <br />Signature: -74v Date: 1 ZO - 9 <br />Title: ow ktit, Pool A— 6:ti).