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Donna K. Heran, R.E.H.S. <br />Director <br />Laurie A. Cotalla, R.E.H.S. <br />As,sistant Director <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />SAN JOAQUIN COUNTY <br />304 East Weber Avenue, Third Floor <br />Stockton, California 95202-2708 <br />Telephone: (209) 468-3420 <br />Fax: (209) 464-0138 <br />Website: www.sjgov.orgiehd/ <br />Program Coordinators <br />Carl Borgman, R.E.H.S. <br />Mike Huggins, R.E.H.S., R.D.I. <br />Margaret Lagorio, R.E.H.S. <br />Robert McClellon, R.E.H.S. <br />Jeff Carruesco, R.E.H.S. <br />Kasey Foley, R.E.H.S. <br />Facility Name: l'eerLzoo,A <br />Facility Address: }1Ts2o7 <br />Owner Name: C-icia r-v\av-NCTh (-LC- <br />Authorized Representative: E,kc,k 4e_y-y-\alv-- <br />I tAftT Wecv\ctiriAe-P 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 <br />cover(s) will be installed over the equalizer line(s). Equalizer lines may <br />have to be separated by 3 feet, measured from center to center of pipe. <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: <br />Signature: <br />Title: <br /> <br />Date: 0(09 <br /> <br />17(