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Site Address: <br />i k VTTUI-1, - _ _ <br />Lo.4.L� &-- <br />� <br />Company Name: f ? `kr.�" License #: <br />L.%v 6 4� <br />1. That a representative or I of my company has verified that the Indoor or Outdoor Pump Alarm <br />sounded by lifting the float switch and the alarm light is on and that the pump was tested with <br />the float switch. <br />2. If applicable, that myself or a representative of my company has verified that the Indoor or <br />Outdoor Filter Alarm sounded by lifting the Float switch and the alarm light is on. <br />Date: <br />Print Name: <br />Signed: <br />Please upload to your permit in Citizenserve when completed. <br />Final Inspection and certificate of compliance cannot be issued until this form is received. <br />