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COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY
DEPARTMENT OF ENVIRONMENTAL HEALTH
ENVIRONMENTAL HEALTH SERVICES
SUPPLEMENTAL REPORT TO SAN. FORM # DATE
SUBJECT PERMIT NO.
ADDRESS 5 1 ao-j-41va-1
REMARKS:
INSPECTOR
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DEH -SAN -116 (Rev 2/96) Distribution: WHITE—Office; CANARY—Owner; PINK—Office
COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY
DEPARTMENT OF ENVIRONMENTAL HEALTH
District Environmental Services Division
District No. 2
PPOJECT NAME
PROJECT LOCATION
OWNER / CONTRACTOR S
POOL AND SPA PLAN CORRECTION
Plan No. QO _0
The plans are now approved subject to the conditions listed below.
Date /0 �-3 (0 0
oe t,
n, iCiOM jpv <<r p� Ot . P 66 1 -
CONSTRUCTION INSPECTIONS: 8ontact theSn Plan Checker for pte-gunite and pre -plaster inspections at least th= (3)
working days in advance.
A FINAL INSPECTION MUST be made upon completion of all work including fencing, safety equipment, and signs.
APPROVAL to operate shall not be granted until the facility has passed the FINAL INSPECTIONS and "APPLICATION TO
OPERATE" has been completed and PERMIT fees have been paid.
REQUEST FOR FINAL INSPECTION SHOULD BE MADE AT LEAST FIVE (5) WORKING DAYS IN ADVANCE.
Plan Check By _ [� Phone ( )
acknowledge the corrections noted herein and as indicated on tq&-�lans and agree to incorporate them during construction:
Signature
Date
DOH -SAN -181 (Rev 11155) Distribution: WHITE—Office;
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n, iCiOM jpv <<r p� Ot . P 66 1 -
CONSTRUCTION INSPECTIONS: 8ontact theSn Plan Checker for pte-gunite and pre -plaster inspections at least th= (3)
working days in advance.
A FINAL INSPECTION MUST be made upon completion of all work including fencing, safety equipment, and signs.
APPROVAL to operate shall not be granted until the facility has passed the FINAL INSPECTIONS and "APPLICATION TO
OPERATE" has been completed and PERMIT fees have been paid.
REQUEST FOR FINAL INSPECTION SHOULD BE MADE AT LEAST FIVE (5) WORKING DAYS IN ADVANCE.
Plan Check By _ [� Phone ( )
acknowledge the corrections noted herein and as indicated on tq&-�lans and agree to incorporate them during construction:
Signature
Date
DOH -SAN -181 (Rev 11155) Distribution: WHITE—Office;
COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY
DEPARTMENT OF ENVIRONMENTAL HEALTH
ENVIRONMENTAL HEALTH SERVICES
SUPPLEMENTAL REPORT TO SAN. FORM # �- /� 0r DATE
SUBIECT� Q. PERMIT NO.
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__•�-... __ INSPECTOR'
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REMARKS: o C.c� i0�n.� s •� �ti :�;. r h r, 1 G, .�, � 1r o j , S11 fi . pr0k
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DEH -SAN -118 (Rev 2/96) Distribution: WHITE—Office; CANARY—Owner; PINK—Office