HomeMy WebLinkAbout29 North Apartments Pool PERMIT 05 10 16.LS.PDFN.C. Department ofluvikoruneut and Natural Resources
rt["4on, of Environmental HeaM
PUBLIC SWINMING POO
OPERATION PERMIT I
Time In: 0 1 ' 5 6 [] am Time Out: 2 : 3 0 Dam
[E PM - -Rpm
Total Tirne° 34 minutes
idtatificafien NumbeT 2 0 1 8 5 0 0 1 0 1
I
Permission is granted to:
a 9 N 0 R T H A P A R T M E N T
0 tv ner or Operator of
NIOIR,T,H, A,P,AIR.T,M,E,NIT,S, I I
Name of Public Swimming Pool
to operate a public swimming pool as defined in G.S. 13OA-280 and 15A NCAC 18A .2500 at
Address 1 1 4 a 9 T H A V E N U E D R I V E N W
C ity H I C K 0 R Y ST N C zjp a 8 6 0 1
County Catawba
Type of Pool: (check one, E,* Swimming Pool - Seasonal Swimming Pool- Year Round
FWading Pool - Seasonal Wading Pool - Year Round
Spa - Seasonal Spa - Year Round
Water Supply: i-1 - Community Waste Water System: 1-1-Community
Territory #: 01
i M.
MM
*Expiration Date: 1 0 / 3 1
Renia*s
FOR OPENING PURPOSES ONLY.
10-JUMM10
N.C. Depsunnent of EnNironment and Natural Resources
Di-sision of EmNitonraental Health
2018500101
Owner or Operettor
SUAKAIM0
Date issuetl
Status Code: I
to operate a public swininiing pool as defined in G.S. 130A-28,0 and 15A NCAC 18A.2500 al
MIEW121111MEAM111=091
onsmainum
St?va A ddws qfPoolLoccition
A r 60=0 -
County
Type of Pool: (check onS Willi Ming Pool
M Wading pool
F� spa
E] Other (describe)
Signed: Agent
0 le,
�,PM;Tiioyfn nrant d-.\,atural Resources
Di , %ac-QfEnvimq Health I1
Expiration Date:
111 1 11 11 1 1 1 1 1 IIIAIM■III !I I I I
MW nzg��
Purpose, General Statute 13OA-281 states "No public swimming Pool may be opened for use uni ess the owner cc operator has obtained
an operation pertnit issued by the Deparnnent7- General Statute 130A-282 requires the Commission for Health Services to
adopt rnles including requirements for application review, expiration, renewal, widrevocation or suspension of an operating
permit, Those rules are contai ned in 15A NCAC 18A 2500,
This fonu is to berried as the permit specified above,
Preparation: Local environmental health specialists shall issue a permit ever-yr time a new or reissued permit is indicated- Prepare an
original and one copy for:
I - Original given to pool owner or operator,
2. Copy for the local health department.
In the event the permittransition al permit is suspended or revoked, complete- the Suspension',Revocation, forna (DE - al
400913),
Disposition: This form may be destroyed in accordance, -,%ith Standard 8.13.6., Inspection Records, of the -Racords Disposition Schedule
published by the NrC, Division of Arcluves and Histon,,
Adchtional for may be ordered from: DiNision of Environmental Health
1632 '-Mail Service Center
Rai ei gh, XC 2 "699 -163 2
(Courier 5 2-01 -00)
EH S 3962 (ReNised 7 D5)
EnAironmental Health Senim section ()teview 7,08)