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Pump and Alarm Verification Form <br />Site Address: <br />1S <br />Company Name: s �i.� Ol License #: <br />�� �l` � � <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: j�l <br />Print Name. 12A _% 7 `4 a--, <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 />