HomeMy WebLinkAboutBaymont Pool Permit 500098 06 02 17.GK.PDF"k y -C Department oftaviroammiand Samral Resoorres *Updare Existing Factlit''?
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PUBLIC SXVITMAIING POOL New Fadlity W - 2 0 1 8 5 0 0 0 9 8
OPERATION PERMIT
Old facility M
Time In,, 0 4 '- 0 9 Time Out! 5 " 3 8 am eats ISSUed' 0 6 / 0 5 a 0 1 7
1E Pm - -WD" PM
Total Tin*: I hr 29 m�nutes *Status Code:
Pennission is grantedio:
B A Y M 0 N T I N N
0 w ner or Operator of
B A Y M 0 N T I N N
Name of Public Stvintrving Pool
to operate a public swimming pool as defined in G.S- 1.30A-280 and 15A N'(,AC 18A �2500 at
Address 1 1 2 0 1 3 T H A V E D R S E
CIIY H I C K 0 R Y S T N C zip a 8 6 0 )
County 1 8
Ty) e of Pool: (check one) Swimming Pool - Seasonal Swimming Pool- Year Round
Rading Pool HWading Pool - Year Round
HSpa - Seasonal Spa - Year Round
specialized - Seasonal HSpecialize ear Round
Wate r Supply: 5-5-?Aun�dpallCommuroty Waste Water System : 3-S - Munibipalfc-mlawnity
1655 - Kain, Greg, f
EHS: Signed Agent
. C I nep , Mt 0, invlf Resources
rh%isim. of Envirotmettal Health
*Expiration Date: 0 9 .1 9 0 1 7
Remaiks
C'Slify"I
A' V11 k M A p
4000
\,,C, 1>PaTment of Emronment W'Natur4, Resour mes
Division of Emironmetind Health
20185000198
PUBLIC SWINMING POOL
Pentrission is grattted to BAYMONT INN
Owner a- Opeyaror
m
V . mne qfPubhc Swimming Pool
to operate a public swiniming pool as defined in G.S. 130A-280 and 15A NCAC 18A, .2500 at
1120 13TH AVE DR SE, HICKORY, NC 28602
StrwAd&ess qfPoo,,Lorai'on
18
Type of Pml-1 (check one) Swi iiming'1?001
Wading pool
Spa
Specialized
Other (describe)
Expiration Date:
M�M# M
S iq ned Agent
N,
offm -it it d Natural Resoura91-
rkpattment
Dinisim of EnvimtmmimW He th
purposneTM Statute, 1_30A-28 I state's ""No public SAimaling pool may be opened for use unless tits owner *' qxrdor has obtained
an opffationpetmit issued by the Depmtment7, General Stdute 130A-282requires die Conunission for health Smices to
a4dopt riges inclucling requirements for application review, expiration, retrewal, andf evocatim or, suspension of an operating
permit, Those rulas, are contmaod in 15A NCAC ISA,,250,0
This fomt is to be used. as the it it specified abovo.,
PreWsionl- Li zi emironmental health speciMists shall issue a perinit evety time a new m, reissued permit is indcat ed, Prepare an
original and one ccpy for:
1, Origin& gi%,en to pool owner or operator,
2, Capy ferr the I ocal health drpa un mt.
lit the ervent the "mitl1ramitiomd it it is suspended or revoked, complete the Sus pensionides ocatitan form (DE4sR,
4,009B)
Disposition: This form maybe destroyed in accordance %vith Standard 8,13 .6, Inspection Records, of the Roror& Dispostil'on Schedule
published by the NNC, Division of Archives md Histon,
Additional forms may be or&red fr=7 INNisifan of Environmental Health
1021 Nlati I Smice Centor
Raleigh, NC27699-1632
(C-mrier 52-01-OQ)
EHS 3962 (Re%iscd T05)
E m-tionniental lit ith Ser%i ces Section (Review 7 M)