Actuel Page 1 Page 2 Aperçu Personal information on this form is collected under the authority of the Public Health Act, Chapter P-30.1, Sections 55 and 58 and the Public Health Act Swimming Pool and Waterslide Regulations, Chapter P-30.1, Section 4 as it relates to the operation of a swimming pool and waterslide. If you have any questions about the collection or use of this personal information, you may contact the Manager, Environmental Health, at 902-368-4792 or toll-free at 1-800-958-6400. Identification Application Type - Sélectionner -NewRenewal Nom de l’entreprise/organisation Prénom de la personne-ressource Nom de la personne-ressource Adresse 1 Adresse 2 Ville, municipalité, communauté Province Code postal Exemple : C1B 0X1 ou 12345 Pays Téléphone 1 Exemple : 902-555-5555 Téléphone 2 Exemple : 902-555-5555 Télécopieur Exemple : 902-555-5555 Adresse courriel Pool Location Enter location of pool if different from address above. Address City, Town or Community Province Postal Code For example: C1B 0X1 or 12345