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Site address of pool(s) <br />34,46, (74, 95.74 ,7 <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 />Print name P9-71 E4/- Date <br />REG/ o/r/N- A4,44/4-,c,< Fog Fgiaew-- /tow& g‘t emr- <br />Signature •iLe-f <br />Address <br />City 1?)72.164.711.,, St Zip fq‘ <br />Telephone LE,14:) 75-e-t) <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 />Id <br />City <br />E12,.'24. 2000 17: 42 K544:30696 <br /> <br />alTHR I E ELECTRIC: <br /> <br />PA13E 02 <br />PUBLIC HEALTH SER <br />SAN JOAQUIN COUNTY dtIV ENVIRONMENTAL HEALTH DIVISION <br />Karen Furst, M.D., Health Officer FEB 2 8 2000 <br />304 East Weber Avenue, Third Floor • Stockton, CA nAVIRONIVILNTAL HEALTH <br />209/468-3420 PERMIT / SERV10E$ <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 and send to: <br />Sao 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