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6 Site address of pool(s) 809 Mill Springs Court <br />City Stockton, CA <br />Number of swimming pools, spa pools, wading pools or special purpose pools at the site <br />1 Swimming Pool 1 Spa <br />I verify that 1 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-1) of the California Health and Safety Code. <br />Print name Omar Al- indi Date- 6// if I ci-e) / • Signature <br />Address <br />CitA <br />Telephone( 209 ) 956-9234 <br />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 />6809 Mills Springs Court <br />Stockton, s i CA zip 95219 <br />PUBLIC ItEALTH SERVAITS <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 />Noz_th Point Villas Hnmps Assnr'i <br />Please attach a copy of the completed and signed inspection permit or report from the local <br />building department 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 />A Division ,r SanJoaquin Counry Health Care Services