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MAP-29-00 THU 09:50 I I i t ea 2094644210 <br /> <br />FRdi : <br />JUIA-1.0-91, SA1 <br /> PHOIE. NU. r: <br /> 4. 19 1997 06:03A1 P2 <br />PUBLIC HEALTH SERVICES .., ..:...—, t <br />s AN SOAQUIV COLINT'Y <br />ENV <br />Karen Furst, M. NI.2.1-1., Ilealth Officer <br /> <br />:I tio, Ilt.ONIASNTAL IlEAITH DIVISION <br />304 <br /> tat Weber Menne, Third Floor * Stockton, CA. 0201 <br />9/d6i1-34.10 <br />VERIFICATION OF <br />computs.NtE, WITH CALIFOIINTA HEALTH AND 20 <br />SAYETY CODE, SFCTION 116049.1 (u4) <br />:---..".. <br />.....,..-."."...."'- <br />.•••••••••••-........."-----'''."....--........--..........,..--0",.---.........--a...,,,.......„ <br />-..-.........,. <br />1 Site tbddresa of <br /> <br />C City <br />Number of swimming pools, spa pools, wading poola or spetiol purpose pools at <br />TVIG site <br />J.-"........... <br />•-----.--.....'......../ <br /> <br />.....••••,....1 <br />- <br />6(eirelt,44{, ettN.TkACTCrit," <br />I <br />verify that I am the ovirnedhotte owner association presidentilegallyresponsible perstIll for the <br />above named pool(s) and that I had the pool(s) inspected for eorriplien te with Section 116049 1 <br />. titittrTS DA)/ rrt/ OreA <br />0107-e410,1.1,5 , _E-r.)e. <br />(6.-dof s taw camorlaio motel =Osiers Code.. <br />Print none ,A lir:8_11,1y "1-7fiadi <br /> <br />I <br /> <br />Satuz i* -17/ <br />L Address13_15-0 1 <br />City _212‘16:12-1P-12------ St 1.--- Zip <br />Telepho11e <br /> <br />,..—._....-7,—__________ <br />0 <br />ndicat Theo Is no pool light in tdive pooKs). Iing there is no pool light mans there <br />t5 no light fixture, light casing, or recessed light niche, whether working or mot <br />working, within the confines of the pool shell ____—_—_-------w.,.-- <br />Please attack a copy of the completed and sivad inspection penult or report front the local <br />building department or the qualified contractor and send to <br />( <br />San Joaquin County <br />Public Health Serriees <br />Environmental Wraith Division <br />Recreational Beath "Program <br />304 at Weber Mense, Third Mar <br />Stockton, CA WO <br />A Di, ..ion til ian toactuin C.,listly. i teat* Cary ierr.:,.. <br />W*NI