HomeMy WebLinkAboutHickory Trace West Permit 500091 05 18 17N.C. seaman ofEmdmnmmr aed Namnl Rmarm
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PUBLIC SWIMMING POOL
OPERATION PERMIT
'Update Existing Facility?
New Fa HWHD: 1 0 1 8 5 0 0 0 9 1
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Tans In:0 1: 0 4 Om T.ne ac a: 1 ®nm 'Date Issued 0 5/ 1 8 / a 0 1 7
T04 Tyne: 47 minutes 'Status Code: I
Permission is granted to
P R O F E S S I O N
A L M A
N
A G E M E N T C 0 I N C
owner or 6peiemiof
H I C K O R Y T R
A C E W
E
S T
Name otPuelie Swimming Pool
to operate a public swimming pool
as defined is G.S.
130A-280 and 15A NCAC 18A.2500 at
Address 1 1 1 3 5 T
H 5 T
N
E
city H I C K O R Y
County 1 8
Type of Pool: (check one) BSwimming Pool -Seasonal
Wading Pool -Seasonal
Spa - Seasonal
Specialized - Seasonal
Water SuppY ss- menideescanmeniy
Territory #: 01
ST N C zip 1 8 6 0 1
H
Swimming Pool -Year Round
Wading Pool -Year Round
Spa -Year Round
Specialized - Year Round
Waste Water System: as-tdnnoeauc nky
EHS: 1656-Keln,nmg Signed � I` n- `*t Agent
Dimxma`�m Fn Hadi mdVamL Fminm
Diwtlm otEeuim®ema Hd0
-Expiration Date: 0 9/ 1 9 /.1 0 1 7
Remeha
4000
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2018500091
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Nmtifiatim Nadu
PUBLIC SWIMMING POOL
05/18/2017
mm EMaee
OPERATION PERMIT
samscoua I
Pemlission is granted to PROFESSIONAL of HICKORY TRACE WEST
Nm;eofPudicS ming Pool
to operate a public swimming pool as defined in G.S. 13GA-280 and 15A NCAC 18A .2500 at
1223 5TH ST NE, HICKORY, INC 28801
3nmrAdbessofPool Loconon
18
cowly
Type of Pool: (check one) ® Swimming Pool
Wading pool
Spa
Specialized
Other (describe)
Signed: W � Agent
N.C. Dep fF 'mvmmemdNmva Remmns
D,sivmaEmimmmW Halo
Expiration Date: 09/29/2017
Remarks:
-----------------------------------------------------------------------------
wsrnDCTtors
Pn : Genual Stmuu 130A-281 slmes-Nopublic smmminpool may be opined fm uuunlms Ne osraaopusm has opived
m opmEm pvmie issmdby the Depmmmt'. Gmval B[mute 130A -2H2 rzwirmde Cm®issim to Health Smicm to
adopttdmindudne«wh®mtmNl Review,mprmim,rmewd, mdrewmdmm mspmsimdanopaativg
pmmir'Ihoumlm n crosmvetl iniv 1 15A NCAC CI18A 5500.
Thistam is tobeusedaz depvmit specifid above.
NeEmaim: Lmd mrirmmmtd health spadips shall ismeapamit every time avewprassuedpemit is wdm[ei Prgwean
mining and mecapy for.
1. Grind gi m pod owpup
2. Capyfmlhclaal hdd, depmentamc
]oche mmt thepmmibhausitio dmmit is suspended mrevohM,mmdete me S9spmsimrRevosmim fpm(DENR
4009B).
Disposition Thistam may be desnoyelis acamdmce ndt6Stmd9rd BB 6..]uspeim Records. d6eRecoMs Dispmiam Sdv
NtA ished by dse N C. Divivm of &cAvu and f b upy.
Additional fmrnm bemdredfi®: Division dpnr%mmmml HmI6
1632 Mm'1 Service Gmtm
Mask NC 27699-1632
(Crain 62L1(b)
EM 3962 nH utd M)
Eovirroa mal Hmhh Services Semm(Review 7N8)