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BPP-14-1939Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-229709 Permit Number: BPP -9-14-1939 Scheduled Inspection Date: March 18, 2015 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: , Work Classification: Repair Job Address: 1090 NE 92 Street Miami Shores, FL Phone Number (305)987-0644 Parcel Number 1132050270410 Project: <NONE> Contractor: GEPAT CONSTRUCTION AND ENGINEERING CORP. Phone: (305)491-9107 Isuuamg uepartment comments REPAIR POOL PLASTER INSPECTOR COMMENTS False March 17, 2015 For Inspections please call: (305)762-4949 Page 21 of 34 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-219109. Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid March 17, 2015 For Inspections please call: (305)762-4949 Page 21 of 34 A Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION PBUI-L'DING ❑ ELECTRIC ❑ ROOFING SEP 0 5 2014 BY:.�_ a_ FBC 20 Master Permit No. � q ` Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: t ®q®A)F,(- Tj 2.r� Sf — City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: II 32CS,. oo9:7 ""OW a Is the Building Historically Designated: Yes NO Occupancy Type: Load: OWNER: Na/m'e (Fee S``im��plle Title Address: 1 `t5 k) t--- `f' City: "k (6t^ _ Construction Type: Flood Zone: BFE: FFE: -TS l �j �:(CQS° 64�e-Vhone#: State: 2-3(3-7 Tenant/Lessee Name: Phone#: Email: C[ CONTRACTOR: Company Name: Phone# 1 91-7�tLc!�7 Address: City: 9. OPPS State: Zip: 3--� -z Qualifier Name: �ot"(7�i Utt!!s Phone#: State Certification or Registration Mc Peai 4t591242- Certificate of Competency #: _ DESIGNER: Architect/Engineer: hone#: Address: City: State: Zip: Value of Work for this Permit: $ e CO Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New [Repair/Replace ❑ Demolition r.� r - i Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ ( t�;O" CD CCF $ Q CO/CC $ Scanning Fee $ 9 Radon Fee $ :Z" '� f5 DBPR $ � ' Notary $ S • QD Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to ttachment. o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection w ' occursrsen J days after the building permit is issued. In the absence of such posted notice, the inspection will not be app d and as �tio,n,ee will be charged. Signatu or AGENT The foregoing instruments was acknowledged b�,to `e me this 9 day of -'JAT . 20 1 , by P W � f who is personally known to me orwho has produced,g-jl. NOTARY PUBLIC: Signature CONTRACTOR The foregoing instrument was acknowledged before me this \ day of 1--y . 20 �� , by who is personally known to me or who has produced (�--Ly (L-7 as identification and who did take an oath. NOTARY PUBLIC: \�` nuinuiiii Sign: ` a v,4��1� Sign: Print:GERALD P911"FAM --7 Sign: Print: p310612D1 Seal: NOTA Seal: STATE OF FLORIDA • COMMOFF091514 cs'' E*ku X10=18 "p" ,r ib �r,,xi�x�d�sww�x�x�s�x�xt�w APPROVED BY 7 t� Plans Examiner Zoning a Structural Review Clerk (Revised02/24/2014) RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD - CPC1458242 The RESIDENTIAL POOLISPA CONTRACTOR: Named below IS CERTIFIED ,R ed Under the provisions of Chapter 489 FS. Expiration date. AUG 31, 2016 VILLA, PATRICIA ti 4 GEPAT CONSTRUCTION MND ENGINEERING CORR 3 k zr 16590 SW &2 STREET SOUTHWEST RANO} S� FL 33331"- . 0 a ISSUED: 08/21/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408210001792 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA. GEPAT CONSTRUCTION AND ENGINEERING Receipt #:GEN2E AL NGRIG CONTRACTOR 'Business Name: CORP Business Type: CONTRACTOR) Owner Name: PATRICIA VILLA Business Location: 16590 SW 62 ST SOUTHWEST RANCHES Business Phone: 305-491-9107 Rooms Seats Number of Machirms: Business Opened:02/03/2009 State/COu my/Cert/Reg : CGC 151614 8 Exemption Code: Employees Machines Professionals 2 Vandina Tvae: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost I Total Paid 27.00 0.00 0.00 2.70 0.00 0.00 29.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is. non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: PATRICIA VILLA Receipt #03A-13-00000546 16590 SW 62 STREET Paid 10/30/2013 29.70 SOUTHWEST RANCHES, FL 33331 2013 -2014 F \ 08/26/14, 13:§57 HP LASERJET FAXAMERICAN QUALITY 3052737339 p.02 e1 _ CERTIFICATE OF LIABILITY INSURANCE ,-°ATESMWDO' _.__...._...._.._......_.._........_._-_-_------------------------,---------..............._....._..._._._._....._..._----•--........._...._-- •--------•-•----- - -------•-----1 08/25/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. - IMPORTAI,t F: ff the certificate holder 1s Ori AC30FT`IOIiAL ItJ8UREit, th® tc es must be andoraed...N SU8120OATION-IS'W'— W—ED, subject to ----------...__. Pa Y(1 ) the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ih>u of such endorsent nt(s). FROOUCER American Quality Assurance 10250 S.W. 56 Street Ste. D-102 Miami, FL 33165 Phone _._._i3051273-3377 -- Fax (305)273-7339 INSURED GEPAT Construction and Engineering Corp 16590 SW 62 Street Southwest Ranches, FL 33331- - -�-CONTACT-............- ----...... ----._...._... - -- ._.._._ .._ PHONE—x t (305)273-3377 OFAN '----- i ..ARARF.SS;,......___.-egagr�sflsouth.rtes......_...»._._._._ .-•----.--- .............___, iNSUREIi(S-} AFFORQINO COVERAGE.......... _. _. _._..__.._.... - INSURER A :.... Granada Insurance Cc ............ ................. IrMURER U. I•. INSURER C I..INSURI?R-D ........ 305 lalsuRtt.,__...--..._.. -- - ..._.»..».. ---._._....__.. __..........._..... _._..._--...---•---._......._._..............I INSURER F: _ TE NUMBER: ta=ancrnu cu manors. INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREb NAMED ABOVE FOfi TH£ POLICYPERIOD-•.»•»..... INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ - -- -TYPE OFNJSURANCE ADO BR E_......._..__..........—......- ---._....... _ -- 1Rtfl$. _._.__POWGY•NUMBER.........._. . GENERAL LIABILITY - .-_..................---.. ..... __»...._ EACH OCCURRENCE )» 1:000,00000 COMMERCIAL GENERAL LIABILITY j DAMPiGff?O RENTEO__ _ ' — --- dA1Ms•MADEW-1 OCCUR ( PRMISSEa Oen,_, i • $ 1 00,000.00 A ❑ 018FL0003720'06252014 Eo t ate $ 5,000.00N > PERSONAL . &ADV GENERAL AGGREGATE $ 1,000,000.00 GEPPLAGGREGATE LIMIT APPLIES PER: I I f----••— --------- .......... __........ �..._....__.—�---__.. -- R POLICY . ❑ C7 i _ i - coldP-OP AGa PRO• I i l.... RO -•.T •------...._...._..- $ _.. -- -- — —---.._._..............--...._.... —... —1 —..----.._._...a..._ _....._ I $ AUTOfIlOBiLE LIABILITY COMBINED SIE IGIE LI►difT ANY AUTO 191 a !!t)• .--.-- - ! B'ODILY INJURY (Per parson) '._$_.....__.____•-_--.-_.... _ WNED ❑ �OOSS ASU TOSDULEO y BODILY R! {Per aoddent S - -- HIRED AUTOS -.l AUTO CEO OD fff PROP&- CAMAGE l ODINtELLA UAB -- �_ � OCCUR_.._..._......._. Ut EXCESS UAB 1 EACH OCCURRENCE i $ ` ❑_CLAIMS-MWOE .-..------.__..._.__.._._..__.._.._.._..-----•---......_._....._.. F-1 nr-n I-1 ccve.rr,—. I !-.._..- ---....... .--... ......... ............ t $-- WORKERS CONDENSATION .................. AND - + .._.._....__. .... .- .._... _. _$......_... AND EMPLOYER {R LIABILITY Y!N I ` 1 WC STATU. ["• OTH-, ANY PROPRIETORIPARTNERiEXECUTNE TOl3Y LW1T_S...1.:.-:.. ER.....1........--- O Mandato ry In NNE.)R EXCLUDED? N 1 A I E.L. EACH ACCIDENT $ YYae desaibe under El E.L. DISEASE - EA EMPLOYE $ ____ DESCRIPTION OF OPERATIONS belay i ....--........... ......... ..... .................._.... t .. E L DISEASE POLICY LRollrr $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEINCLES Attach ACORD 101, Additional Remarks Schedule, if more �..-_ .. _...»....____._...._..._.._....._......_... _. _. —_.... apace Ee reptdred) General Contractor CGC 1516148 Pool Contractor CPC 1458242 CERTIFICATE HOLDER Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, FL 33138 ACORD 25 (2010108) QF -------- --............. ........ ....._.............. .... _._..._..._......._.._.. ....... .. _.—__.». - . ....... _.... . _....--- . _- CANCELLATION--••--_--.-. i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE j THE EXPIRATION DATE THEREOF, N0710E WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. I AU7fiOR�EDREPREBENTATIVE f,,,, ....»_—_ �+�JC>iWa-tGt✓ J� _ . .... I. ..... ..... — — ......_.. ...........---.._......__---- _.... ®1988-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 7/10/2013 PERSON: VILLA FEIN: 262511387 BUSINESS NAME AND ADDRESS: EXPIRATION DATE: 7/10/2015 PATRICIA GEPAT CONSTRUCTION AND ENGINEERING CORP VILLA POOLS 16590 SW 62 ST SOUTHEWEST RANCHES FL 33331 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tei: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Print Nami Signature: Owner Mate of rtoncta ) County of Miami -Dade ) Sworn to -pd subscribed before me this day, of Xt-, , 20 1 By ► I/I Y`vy (SEAL) Tvve of Identification Mowy Fid - Site of riarme 111 COM- a U9,27, 2or COMM91M • FF 043270 Contractor fl Print Name: Signature: State of Florida ) County of Miami -Dade ) X-1; \`��is i.r y, Sworn to and subscribed efore `day of (' \ 2i�P� By — rcFerI of Identification OF 101\\; I LAYOUT PAGE POOL LOCATION ELEVATIONS /'� 3 'S 1,14 VERIFY ALL DIMENSIONS WITH ACCURATE SURVEY SCALE: 1/4" =1 FOOT IF WATER SOURCE IS A PRIVATE WELL PRE- FILTER WATER TO FILL POOL r' ALL METALLIC ITEMS WITHIN 8'0 OF WATERS EDGE OF/ POOL TO SE BONDED WITH 118 SCUD INSULATED WIRE (u1. / 1 B A. 31n. fisted) FROM POOL STEEL All GROUND WIRES CONNECTED / TO STEEL WITH BRASS GROUND LUGS ....-G.F.I.OUTLET 10' / MIN. AND 20' MNL FROM POOL IF ENCLOSURE IS REQUIRED ADD SCREEN OR FENCE AROUND POOL OR PROPERTY �@��+ / / • • • • GATES TO BE SELF CLOSING AND SELF LATCHING G / • • • sees • • • • • • PROVIDE DOOR AND WINDOW ALARMS AS REQUIRED / / i < & DEEP • •• • • sees • 00.006 sees :ese• • STEEL OVERLAP ® 46 TIMES DIAMETER / \ • ESTABUSH THE LOCATIONOFALLUTM/ES AT /' • • • • • SWIMMING POOL CONSTRUCTION SITE AND HOLD I' • • • • • • e • • • • • • is MINIMUM CLEARANCE DIMENSIONS ESTABLISHED *so* • • • • • • • • • BYTHELOCALREGULATORYAOENCY. ALLOW /' MIN. 10WORIZONTAL CLEARANCEPROM /' **:so: • • • • • • i • • e OVERHEAD ELECTRIC LINES TO POOL WATER. /' e • e e • • • • : • • • • •I• DECK SHALL HAVE A BLIP RESISTANT FIN1961' G11ITH •eee•• • e NO SHARP EDGES AND BE POSITIVELY SOPED POOL 20' x28- ` • e • • •I FOR DRAINAGE / •ee•ee i••ee• METER • • • • i • • • ••e••ie •• • •••• • RESIDENCE I sees 1 POOL EQUIPMENT It POOL REQUIREMENTS: 211 p SELF-CLOSING/ SELF -LOOKING PROVIDE WEEP GATES REQUIRED LE8 AND DEWATERING PUMPS FENCE: 4' HIGH (MIN.) AND ANY OTHER N ETHODS NECESSARY TO 6 ' AND NON -CLIMBABLE PREVENT THE PW SIBILITY OF THE POOL IF NEIGHBORS REMOVE FENCE/ FLOATING DUET0 HYDROSTATIC UPLIFT WALL, OWNER MUST REPLACE PRESSURE WHE 4 17HE POOL IS EMPTY. I WITH PROPERTY BACKFILLING OFE POOL SHALL BE DONE CAREFULLY TO S URE THAT NO DAMAGE TO THE PIPING OCC 8 AND BACKFILLING SHALL BE S' DEEP DONE WITH CL SOIL FREE FROM ORGANICS AND DEBRIS ANC I HALL BE COMPACTED 60 THAT NO VOIDS EXIST P IIOVIDING A FIRM BEARING FOR THE DECK ALL PIPING TOB IVC SCHEDULE 40 MINIMUM ' AND ALL PRESS PIPING AND MAIN DRAIN I -, hlli1nSuli Shores Vi1E_qq_ PIPING MUST BEE86URE TESTED PRIOR TO j -------------------------- --------------------------- P ------- --- GUNITE (CONCRIE 28 ft. THIS IS NOT A DI I� POOL. �1 SWIMMING POOL F ILL HOSE To DEPT� BE EQUIPPED WtTl I rCUUM I u BREAKER I / q LOCATE POOL RE NS DOWN PC E E PT SE"�MMIN. BELOW TP EPOOL� BBF T TO COMPLIANCE WITH ALL FEDERAL I _ _ T �J� z TAT ^JD COU JTY RUL�EyS AND REGULATIONS " �� 4 FROA :MATT FAX NO. : K Aug. 31 2012 12:31PM P1 pool safory nets & covers Tw15 KATCHAKIQ Is ASTIR F1346-91 COMPL ANT The i!catchakid pool netmanufactured in Texas by Katchaldd Inc. is in compliant with the American -%cWty for Testing and Materials (ASTM) under the code F134641 for manual safety covers. The Katc hakid pool net meets the criteria of all of the ASTM's dema"nS "Hies of performance tests and labeling requirements. Some of the conditi0m for ASTM Specification F1346-91 include: ' The Cover should be able to hold a weight of 4861b (3. adults and 1 child) to Permit rams operation. Demonstration that any opening in the cover is sufficiently small and strong enough to prevent the test ot4ect being passed through. Meeting labeling requirements for all covers for swimming pools, spas and hot tubs. While already a quality and time tested product, conforming to the ASTM's code feather provides owners of the KetcWd assurance that they have one of the best form of pool Protection acting to reduce the drowning risk of small children. FACTS: ASTM set codes and standards they do not certify, approve, list or endorse a product To prove a Poduct is compliant and up to a certain ASTM code the product sfiould be tested by an Independent laboratory (ASTM does not accredit laboratories). The laboratory teal then Issue the product with reports illustrating how the product is compliant to that particular ASTM code. To be certain of a quality pool safety net ask to see laboratory reports showing compliance to the ASTM F1346-91 manual safety Cover Gode. FROt� :MATT FAX NO. Aug. 31 2612 12: 32PM P2 "`U.W ""J`` 41-4py of or'rgirw letter dated 17 ,lune 2402) Re: Kat,*,Ildd* Pool Cover Cert3 OWan to ASTM F-1 91(R prcoved 1998) To Whom 9 May Concern: This letter is to c Y that on 30 May 2002, a KafthakideNet Pool Cover rng u bmtured by Ketohakid. Ino. of Houston Texas was tested per ASTM' F-1346-91, gVed: Sfandard Parfonrranc a 4pate''0' for S91W Covers and t abelfng Requirements. for A!1 Covers for Swimming Pools, SP88 and Hot Tubs. The pool cover ClassSfiaatlon and Minimum Qualrf%afion Critona that was required of this n8t is outlined in Section 4 of the ASTM standard. ASTM -1=-1346-91 Section 4: Cover Classifications and Minimum Qualification Criteria 4.1 Not Applicsble 4.2 Manual Safety Cover (MSC) — Provides a high level of safety for children under the age of fte by inNbi5 V their access to the water. 4.2.9 Must satisfy 5.1-5.3, 6.1-6.5, 7.1-7.4, 8.1, 8.2, 8.4-8,92, 9.1_9.4, and all subsections. The results of to tests were as follows: ASTM F-1346-91 Section 5: Materials and Manufacture 6.1 Only materiels not known to be harmful to health, within intended application, shall be used. Meets requlroment 5.2 All nmatetiats and cornponents shall be durable and satisfactory far the intended purpose carder the conditions normally prevailing at the site. Meets requirement 5.3 The Cover shall be nmarwfaotured or fabricated, or both, in ac:oordance with generally accepted, good nu nu%turing practices. Meets requirement FROh :MATT FAX NO. Aug. 31 2012 12:32PM P3 ASTM F-1346-91 Seefion 6: General Requirements fOr Safety Covers InsiallalloMise of Safetycaovers Parties, or both, d�iJeirrstructiorrUs four in�tat Installation shall given the � , or responsible ft ung or a label, or boar, attached to the cover. cr4'm Included In These covers are crab► installed by a factOrY trained and approved pool �fessi+dnal. 6.2 Labels armed to the rover stroll meet the $enWal reqUilOnIGnts described in $.5.4 and .$. Labeling meets requirements. 6.3 Mari»gs for SWW covers shall include, 6.3.1 The rmnufaciumr's name, 6.3.2 Date msnufstted or installed, and 6.3.3 Inst wagons to Mnsumers to inspect the cover for prematUre weer or deterioration. 6.3.4 L bels at%ched to covers shall meet the general requirements described in 8.7.8.8.1, and 8.9. MwMngs and labeling meet the acquirements. 6.4 Fasten/ng rmecharrisms or devices — Ties, aftchment points, anchors, anchorage, and corfols for ar,rtomadc covers or other means of fastening a cover shell Include provisions such as keys, combination locks, special tools, device, or Inaccessible locations, and the like, to inhibit children under five years of age from removing or operating the cover. When subjected to the load and perimeter deflection tests described in 9.1 and 9.2, all fastening devices shall remain in their intended, semir+ed, or dosed, or both, positions. After the test, the intended perfomrance of the device should not be impaired. Fastening devices and aftchment points meet requirements. The detachment mechanism and procedure Is sufficlently difficult to prevent a five-year old from ramovin+g the net All load tests were met. 6.5 Openings —"rhe cover shall be designed in such a way that, when it is tested by the test method described in 9A., any opening in the major component or between the edge of the cover and the top suriacso of the pool or spa does not allow the test object to pass through. The test object shall not gain soma to the waiter, or be subject to entrapment. Meets requirements, Access to the pool was restricted in all tests. FROM :MATT FAX NO. Aug. 31 2012 12:33PM P4 ASTM P-1346-91 Sin 7: Performance Requirements q is for Safety Covers 7.1 StalyG Load In the case of a pool with a width*or diameter of greater than 8 fromthe periphery, the cover shall be able to hold the weight of 485 ! (2 adults and ft child) to permit a rescue opemtion. Passed. 7.1 •'l 'n the case of a pool with a width or diameter not greater he cover shall withstand the weight of 275 lb. {weight of 1 child and I adult). C►ompCarle shall be darted by the test method described in 9.1. Nat APpg+cable 7.2 PadlmterDsfibWOn — The cover snail be designed in such a way that, when it is tested by the lest method described in 9.2, defisdOn of the cover does not allow the test object to pass between the cover and the side of the pool, or to gain access to the water. Passed. 3 urfScO Drainage --The cover shall be so constructed, or Incorporate a system, or have an auxiliary system provided, that when used in a cwrdance to the manuiachwees k truc tions, shall drain substantially all the standing water from the cover within a !mod of 30 min. after cessation of normal rainfall. Compliance shall be determined by the gest in 9.3. passed. 7.4 Opening Test — The tests shall be conducted by the test method described in 9.4 to demonstrate that any opening in the major component or between the edge of #w cover and the deck surface or coping wall, or both, and the top surface of the pool or the top sUafam of the spa is sufficiently small and strong to prevent the opening from being forced to a size that will allow the test object to pass through. Passed. ASTM F-1346-91 Section 8: Minimum Label Requirements for All Covers fot SvA mrning Pool$, Spas, and Hot Tubs 8.1 PrOdcict Label - Required to identify manufacturer Shall meet requirements of 8.5.1 and $.8-8.8.2 Meer requirement 8.2 Warning Labels - Required of all covers 822.1 Signal WbAt WARNING 8.2.2 Safety Alert Signal. l FROM :MATT FAX NO. Aug. 31 2012 12:33PM P5 rea"ir law 8.6 Leiter Style a.e i Signal word • Sans Serif — Upper case only 8.6.2 Message Panel + Sans Serff — Uppercase orliy 8.6.3 Acceptable Legodng Styles • Medium Helvetica Bold Helvetica News Gothic Bald Meaf$ Requirements 8.6.4 Plac erft— Location shall be such that the message Wal. 8.8.5 —13e readily visible to the intended viewer, taking into consideration an possible viewing angles 8.6.6 — Alert the viewer to the potential hazard in time to take appropriate action 8.6.7 -- Label must be so as not to be removed in the fitUng process Meets Requi rMent 8.7 L itO Expectance — Debet shall have a reasonabie expected Life with good color stability and word message legibility. 8.8.1 P10tecthm - Placement of label should provide protection from foreseeable damage, fading, or visual obstru HICIn caused by abrasion. ultraviolet right or substances such as chemicals or dirt. 8.8.2 AitachmGnt - The label shall be attached permanently to the product so that it cannot be easily removed. Mss Requir+emw is FROM :MATT FAX N3. Aug. 31 2012 12:34PM P6 t 8.2.2.1 Word M aUage: AVOID DROWNING RISK • Shaft be the fast message under the signal word. 8.2,2.2 Ad anal Nord AoftwVs. Statement f ufred far the falfo � hazards — Note. far above table - applicable warning Label meets requirement 8.8 Not Agplioable 8.4 Color for Safety Cover Warning Labels 8.4.1 Signal and Message word panel may be same color and conftWng with lettering Meets requirement 8.5 Waftnq Labels — Leiter Size 8.5.1 Lettering shall be of a size that enables a person with normal or corrected vision to read the saf+sty sign or labol ata safe viewing distance from the hazard. 8.5.2 Signa! Word + Letter height shall be at least 50% greater than the "ec Md height of the message panel wording. 8.5.3 SaA* Alert Symbol Shall precede the signal word + Shall nave base on the same horizontal line as the bass of the signal word. + The height of the safety alert signal $half equal or exceed the signal word letter height. FROM :MATT FAX NO..: Aug. 31 2012 12:34PM P7 8.8 l7eplacemerrt -- Product/waming labels should b .. . they no longer utast legibility requirements far safe �� by the prodrrc# user wl�n a*nde&m7*-1- Incaseswhereproducts have extensive exP cted rr a Wnces Wised to corcdlfty the product user should be We to obtain replacement labels firom the rrfet►ufaoturer or responsible ply. Meets requirement 8.9 1n8t ucficWUse Label — Any Product instructions or use labels not aft to the Product, intended to be viewed by the consumeduser shah contain in Its, contents the sante applicable warning label ss set forth In 8.246.3. Meets requirement 8"0 Packagings label — if Packaging is intended for product display to the car>sucnerluser, applicable warning label as dssaibed in 8.2-8.8.3 shall be placed on the printed side, of the Package intended for display andlor consumer information. The label shall be Printed on or affixed to the package and not easily removable. Mseft requirement—KetchakI& nets are not sold directly to CLS10mers through retail stores but are only available through factory trained dealers and instaffers. 8.17 Cornpriarttae Labeling — All labels shall note the spe0c cover classffication. Meets requirgm nt ASTM F 1346-91 Section 9: Test Methods for Safety Covers 9.7-9.4These sections describe the specific tests and test objects that are required to be pertained in order to satisfy the requirements of Section 7. All of the tests were performed and the results are indicated in the Section 7 paragraph of this report. C, vera t De ermin, a -ion The tested icatotolddrNe# Pool Cover PASSED all of the reVremerts ofASTW1346- 9h Genera/ Requirements, as specified in Section 6, ASTIl11r F1346-91 P&*ffrence RequiremOnts, as specified in Section 7, and ASTM-FI346-91 MkdmuM Label Requimments, as specified in Sections 8. Very truly yours, Irrter-City Testing and Consultina 4, 7D R. Stephen Wortman Gordon H. Damara Consulting Engineer Director