HomeMy WebLinkAboutCatawba Ridge PERMIT 500051 05 18 17N.C. Department ofEmironment and \atural Resources
Division of Environmental Health
PUBLIC SWIMMING POOL
OPERATION PERMIT
Time In: 1 1: a 3 0 pm Time Out: 1 1 5 5 2am
Pm I ❑ m
Total Time: 32 minutes
Permission is granted to:
*Update Existing Facility?
New Facility ID: x 0 1 8 5 0 0 0 5 1
Old Facility ID:
*Dare Issued 0 5/ 1 8 f a 0 1 7
*Status Code:
S H 0 0 K & T A R L E T 0 N
Owner or Operator of
C A T A W B A R I D G E
Name of Public Swimming Pool
to operate a public swimming pool as defined in G.S. 130A-280 and 15A NCAC 18A .2500 at
Address 1 7 5 5 a 0 T H A V D R N E
City H I C K O R Y ST N C zip a S 6 0 1
County 1 8
Type of Pool: (check orae) ❑O Swimming Pool - Seasonal
❑ Wading Pool - Seasonal
F-1 Spa - Seasonal
r-1 Specialized - Seasonal
Water Su pply: 5-5 - Municipal/Community
Territory #: 01
EHS: 1654 - Huffman, Jason
*Expiration Dare: 0 5 / 1 8
Remarks
NO NIGHT SWIMMING
F-1 Swimming Pool -Year Round
❑ Wading Pool - Year Round
❑ Spa - Year Round
F1 Specialized - Year Round
Waste Water System.
3-3 - Municipal(Commurity
Signed Agent
N.C.DepattmentofEnviro0�fv
visim afEn4irorunental
a 0 1 7
-'3.3G 'S 1a
3983
V_C_ Depaftment afEmifonment and Natural ResaLrces
Division ofEnv ronmmial Health
PUBLIC SWIMMING POOL
OPERATION PERMIT
Permission is granted to SHOOK & TARLETON
L olvner or Operator
2018500051
Identification -Number
0511$1201 7
Date Lsued
status c ode: I
of CATAWBA RIDGE
Name ofFublie S'67im ming Pool
to operate a public swimming pool as defined in G.S. 130A-280 and 15A NCAC 18A .2500 at
1755 20TH AV DR NE, HICKORY, NG 28601
Streat_4dd-a.s of'Pool Locution
18
County
Type of Pool: (deck one) 0 Swimming Pool
❑ Wading pool
❑ Spa
❑ Specialized
❑ Other (describe)
Expiration Date:
S igned: Agent
N.C. Department of Envi d . Re w s ti
f Di,rYsianofEnvirtrntrnenta�H
18/2017
Rask;: NO NIGHT SWIMMING
INURUCTIONS
purpose: General Statute 13DA-281 states "No public swimming pail may be opened for use unl ms the owner or operator has otxained
an operation permit issued by the Dma imine _ Genera] Statute 134A-182 requires the Commi ssian for Health Services to
adapt rut es including rzquirern nits for application revitw, txpiration, rmevvel, and rvocation or suspension of an operating
permit. Those -ales are eortai ned in 15A ItiCAC I 8 ,2 500,
This farm �s to be used as the permit specified above-
Prcparstioz: L ocal environments) hcatth specialists shall issue a permit evcry time a nein• or feissucd permit is inAcatcd_ Irrepare an
original and one copy for:
1. Original given to pool oamer or operator.
2_ Copy for the local health department_
In the '-Vett the permittrar sitional permit is suTended or revolcee� complete the Suspensicn.'Revocation form {DENR
40)9B) -
Disposition: This form maybe destroyed in accordance with Sunda d 8.B.6., Inspection Records, cf theRacards Di position Schedule
pub] iAcd by Ac N_C_ Division ofArchivcs and ILston•_
Additionalforms may beorderedfram: Di visionofEnvironmenLdFlealth
1632 Mail Service Center
Ral eigh, IFC 2764-1632
(Courier 52-41-04)
EES 3962 (Revised 7/05)
Enviretmettal Heallh Services Section (Review TOR)