HomeMy WebLinkAboutDays Inn Pool 500100 PERMIT 05 22 17N.C. Depatmtent ofEniironment and Natural Resources
Division ofEnviroumartaIHeaIth
PUBLIC SWIMMING POOL
OPERATION PERMIT
Time In: 0 9:.1 6❑ m Time Out: 1 0 x 0 '❑pm
Pm m
Total Time: 54 minutes
Permission is granted to:
*Update Existing Facility?
Nnv Facility Li): .2 1 8 5 0 0 1 0 0
Old Facility M:
*Dare issued 0 5/ 0 0 / a 0 1 7
*Status Code: I
D A Y S I N N- P O O L
Owner or Operator of
D A Y S I N N
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 0 5 1 3 T H A V D R N W
City H I C K 0 R Y ST N C zip a 8 6 0 1
County 1 8
Type check one
)Swimming of Pool: ( )wimming Paol -Seasonal Swimming Pool- Year Round
NWading Pool - Seasonal LlWading Pool - Year Round
Spa- SeasonalHSpecialized
Spa -Year Round
Specialized - Seasonal - Year Round
Water Supply:
5-5 - MunicipallCommunity Waste Water System: 3-3 - MunicipallCommunity
Territory #: 01
EHS: 1654 - Huffman, Jason Signed
N.C. Depamment of En ro an a: e u s
DivAsioaafEn�imnrnen � a!
*Expiration Date: 1 0/ 3 1/.2 0 1 7
Remarks
SKIMMER EQUALIZER PLUGGED WITH HEAVY RUBBER PLUG. UNABLE TO REMOVE PLUG BY HAND
AS ATTEMPTED BY EHS.
Agent
C Of
Rom iiri
Rom c013
3899
N --C- Department of Enlir¢nmem and Natural Resources
DivisionofEEvirunmental Health
PUBLIC SWIMMING POOL
OPERATION PERMIT
Permission is granted to DAYS INN -POOL
Owner or Operatar
2018500100
05/22/2017
y
Identification -lumber
0 5122/20 1 7
Date Issued
Status Code: I
of DAYS INN
NameafPubli:c SWimmingPool
to operate a public swimming pool as defined in CT.S_ 130A-280 and 15A NCAC 18A _25DO at
172513TH AV DR NW, HICKORY, NC 28601
Strmt.ide,--ss of Fool LoeMon
18
COW2N
Type of Fool: (check ane) 0 Swimming Pool
Wading pool
Spa
Specialized
Cther (describe)
Expiration Date;
Signed: Agent
.N.C. Deparvnmtof vir t _ uses
Diviof Envi
10/31/2017
Remarks: SKIMMER EQUALIZER PLUGGED WITH HEAVY RUBBER PLUG- UNABLE TO
REMOVE PLUG 13Y HAND AS ATTEMPTED BY EHS.
INMUGTIONS
Purpose: Genera) Statute 130A-281 states " No public swimming pool maybe opened for use unless the owner or aperaor has obtained
an operation permit issued by the Dcpmiment". General Stztute 130A-282 requires the Commi ssiarm for Health Services to
a<bpt rues ioc]udog requieementsfor application reuie:w, expir8#i4n, reuewa), ardrev4ca#iou 4r mspension of m opuAng
permit- Thane rules are contained in 15A NCAC 1 SA -25QQ-
This form is to he used as the permit specified above.
Preparation: Local mui ronmmtal health speciAkts shall issue a pernvt every time a nr-w or reissued permit is indicated_ Prepare an
original and one -copy for:
1- Original given to pool owner or operator-
2- Copp for the local health department -
In the event the permit+transitinnal permit is suspended or revoked, complete the SuspensionlRevaration form (DENR
4 Da9B) -
Disposition: Thisformmay bedestroyedin accordasceayth Su mdard8-B-6_Inspeetion Records, ofthe7tacordsDispasitiarrSc3tedrlle
published by the NC- Division cf Archives and Hi story-
A&titiona] forms may beordredfrom- Division of Environmental Health
1632 Mail Service Center
Raleigh IWC 2764$-1632
(Courier 52-01-00)
EHS 346+2 (Revised 7/05)
Envisvrunental Health Services Section (Review 7r08)