HomeMy WebLinkAboutBaymont Pool PERMIT 500098 05 23 16.GK (2).PDFN.C. Dcp2rtment offiaN nment md _Y'atural Resource&
Dkis" af Envintnia
P_ LIT
IBLIC SWINIMING POOL
OPERATION PERMIT
Time In: C7 I : 1 6 [] pam Time []la
0A 5 : 1 1 am
[E rn Em
Total Time,
Identification Number 1� 0 1 8 5 0 0 0 9 8
. . . . . . . . . ..
CAd Facility ID (required if
*Date issued 0 5 D 3 0 1 6
Please use UE010 EIM El 0 10 El R] Ell] 0® letters when f Ming in items with boxes
Permission is granted to:
B A Y M 0 N T I N N
. . . . . . . . . . .
0 iv n er or Operator of
B A Y M 0 N T I N N
. .......... . ....L ...................... - --------- - ------ . ........... .................. . ..... t-11111 - . ........... 1-111111111111 - — - ------........------- - -------------- - ------ . ...- — - — - ------------- - -------------- - ------ . ........... -------- . ...........
dame of Public Swirnmine Pont
to operate apublic swimmmg pool as defined in &S. 13DA-280 and 15ANCAC 18A .2500 at,
Address 1 1 ) 0 1 3 T H A V E D R S E
C 1y H T C K 0 R Y S T N C zip -) 8 6 0 D
L -----
County Catewba
Type of PooL (ckeck one,,) Swimming Pool - Seasonal
Wading Pool - Seasonal
P Spa -Seasonal
Water Supply: 1-1-Community
Territory #- 01
KIM
*Expiration Date: 0 9 1 3 0
Remarks
Swimming Pool -Year Round
Wading Pool - Year Rolu nd
Spa - Year Round
Waste Water System: "' " Community
Signed
Agent
Di%isicn of Erviroinitatal He, ath
a 0 1, 6
N-C. Department ofEnvi=n.e,,nt and Nawral Resaurces
Di-visicnofEnv,rznnienrat Health
2018500098
Pennission is granted to BAYMONT INN
Owner or Operaror
Date Issued
St us Code- I
anle ofPtiblic 54Lwnwing Pool
to operate a public sm-iniming pool as defined in fix& 130A-280 and 15A NCAC 18A .2500 at
S&WtAzj� 0,17pooi 10oat."On
Type of Pool: (check otiinitniniz Pool
Wading pool
Spa
Other (describe)
Signe& L Agent
,N.C, Departmem, rironruemt aNarural Rtso=
O,isim of Emirotmentai Health
Expiratj(xaDatc� 09/30/2016
9=
PUrPOse: Geri eral Statute 13 -2 8 1 states " N� o publ ic sMrnmi ng poct xnay be open redfor use urrl -,;s the owner cc operacr has 01nin eLd
an operati on pennit i s sued by the, Depabn ent"_ Gen eral Statute 13 OA -2 8 2 requires the Commission for Health Senices to
a&pt t'WeS indc[Cfiag r.-Lquirerasits for applicabou review' expiration, rmewal, drevoc-ation or stet pensionof an operafing
pertnit Th,�se rules arecottained, in 15A, T" CAfC 18A,2500,
olds forna :s to he used as the pe=t specifieAkove_
prepaxztio-a_ Local en-6r<n=amtnI hzalthspccialists Shall is5ucapecMit every time ariew of rcissuodpetmu: is inlicaied- Preparean
original and one copy for;
1. Original, given to pool 0vt,'s or operator,
2.. Con, for the local health department.
In the _-vert the permiftransitional pentit is swpemded or revoked_, complete the &spemsioiRevocation fcnari lDEI�a
40'1,qB).
Disposition: T hi s form al ay lie destroyed i n ac cur dan c e wi t h St an &f d 83 . 6_ 1 n spect i on Records, of the Record: Rl :pos � t" 0 n Schedule
pax lb,lishcd'a-
y thc N.C_ Division 4Archivcs an'! TEstory-
Additional forms may be ordiered from Di-,i siren of Environmental Health
1632 it Service Venter
FA feighNC 27699-1632
(Courier _52-01-00)
EH S 396 2 (Reviwd 7,05"�
Em-troarnental Health SEnices Section (Revitw T'OB)