HomeMy WebLinkAboutCatawba Country Club 500018 04 05 23.tif ic,.€0) ' ENVIRONMENTAL HEALTH
Catawba County Government Center
c a t aw b a county 25 Government Drive I P.O. Box 389 I Newton, NC 28658
public health Phone: (828) 465-8270 I Fax: (828) 465-8276
MAKING.LIVING.1EMME1.
Email: EHAdmin@CatawbaCountyNC.gov
Application for Public Swimming Pool Permit
ill- ccrCj
Pool Information f I ID- 40Ic? S h o p IDS
Name ofpablic swimming pool: eI L I,t)h�t- ev�J/17' C�n I;�t Lid .tea r /1
Street address: / / S c{ 00 aid--7 C h:i, i64Jl
City: I M,fAJ. //! State: �C- ZIP: 2.sF'Cf
Type of public swimming pool Swimming pool nWading pool []Spa nOther (describe)
Date constructed or remodeled:OBefore May I, 1993 reef May 1, 1993
Dates of operation: opening date: Sol z S'/ .L 3 Closing date: gkliz 3 opening
Hors of operation: time: /U`,0 0 4 to Closing time: 9, 00 fin
Owner Information
Name of owner: -5-4-,C 0/64,1 -�' J,<i C ((5-t?VI') Owner email: tilt 19 J S 1 C.-e.:. C ct,40- %b a-.ill'
Mailing address: i f-&/ (o 0/14 C?/J/k' &a t>c
L �
City: /1i.liA) -n State:NC ZIP: ���
Contact Person: -3--J .() Litt 1 L.''S c Cr Phone#: ( ?s'- 291 - - -7 Z 7
Operator(On-Site Manager) Information
Pool operator: P\1\`4O\'\ \I\ ' , Phone#:(i tr�o') 5 l V TA c.\ 11
Street address: \v-, \(\> r y e\ W`o 'c 6.
City: i V \\,,i , \ (\ State:NC ZIP: -1,C(sj U g
Pool operator trained by: ational Swimming Pool Foundation (Certificate#: ` 0 �V \ �-1 )
Other(please specify) 1 \ a V k -\h \�U1 V\�.'�
Application Submitted by: rS-14 2L v\ c X t c— , Owner ❑operator
1� >
Signature of Applicant: C ;?" "-- Date: -3-2 Z -2
Purpose General SW tote 1 30A-282requires the Commission Heulth Serckes to ailoptrules governing public swimming peels.The rules in 1 SA NCAC 1SA.2S00require the owner or operator to apply annually
for an operation permit for ea&public swimming pool.This form is to allow owners or operators of public swimming pas to apply for permits.Preparation:The arlommioa requested on ids fermis to be
completed by he pool owner or a'leukemia representative of the owner.The completed"plaint Is mlmitted to the local health department for the county in wilds the pubic swimming pool is located.A
separate appAatia most be completed hr each pubic swimmig pool.Copies:Original te be minima at the local halh department.Disposition:Please refer to Records Rekatioa and Disposition
Sdhedde for County/Disbid Health Deportment whids are polished by Nerh Camino Division of Historical Resources. Reorder.Additional Forms may be ordered from:Division of bwiro.extol Haman,
Department of Enviremnent and Namrd Resources,1630 Moil Service Center,Raleigh,NC 27699.1632,(Cowles 52.01.00)
DEN A 3961(Redsed4/03) Environmental Health Services Seam(Review 4/06)
catawba county
public health
Pool.Drain Safety Compliance Data
PERMIT CANNOT BE ISSUED IF FORM IS INCOMPLETE
A separate form is requiredl for eachpump including circulation,jet or feature.
Name of Pool C(J GJ y. GOc& ,7 (��(J aain- ID#
1. Pump Flow
Pump Manufacturer ,e;0 .<✓' Model/f C�`C 1S pig Horsepower 1,
Maximum Pump Flow at highest speed FROM PUMP CURVE: ei O gpm.P"unp 4isio:Circulation/jet/feature(circle one) ` , �,
Has pump been serviced(disconnected from power for any reason)or changed out in last 12 months? YES/�
Flow meter manufacturer Flow meter reading GPM S '�-p TM
��,�L.r�,`CiS(�
2. Drain Sump Measurements Is drain cover sumpless? Yt ' /N0
Sump manufacturer and model OR: Field built sump(circle if yes)
Diameter of pipe entering sump If inches. Pipe enters through BOTTOM aPrbf sump(Must circle one)
Distance between highest point of outlet pipe and top edge of sump F inches.Sump dimensions /4 A
3. Drain Cover Data—MUST BE INSTALLED PER MANUFACTURER'S INSTRUCTIONS-Attach Instructions to form.
Number of main drains on each pump Z. Distance between main drains(on centers) 3 feet inches
Cover/grate manufacturer 4 ✓a.. 4.0y- l model 12 1 W 16 1 ,VGBA approval 2008/CjAcircle one)
Flow rating from instructions: 41QC (. n ?Car(s)located on pool:Floor/wall(circle one)
Date installed Jam'3 -•2.5 Lifespan 5 y 12 r EXPIRATION DATE
4. Equalizer Covers
Number of operable skimmer equalizers d Have the equalizers been permanently disabled? e/NO
Equalizer fitting Manufacturer ,Model ,Lifespan
Bulkhead adaptor Manufacturer .Model Date Installed
Diameter of equalizer pipe Cover is located on(circle where mounted):Floor/wall
Equalizer fitting maximum flow rating gpm.
Date equalizer cover/grates installed EXPIRATION DATE:
5. Safety Vacuum Release System(SVRS)—Safety Vacuum Release System manufacturer/model#-
You will be required to demonstrate effectiveness during permitting inspection.Date last tested
6. Vacuum Line Choose One
No vacuum line in pool OR Protective cover on vacuum lines installed before May 1,2010,OR
— Self-closing,self-latching cover designed to be opened with a tool on vacuum lines installed after May 1,2010
Full name of person providing this information S %h 3.4/G- Phone number: ea'29 7Z 7
Signature --__------_—_--Date 3"' 7
NCDHHS
Revised 4/1/2022 for immediate use.
•
VGBA-2017 PRODUCT SPECIFICATIONS
(1)
AQ ASTAR" Suction Outlet Fitting Assembly (SOFA)
VGBA-2017 Flow Ratings, Sump Dimensions, I
pool products Certified t0
Sump Flow Path Zone, and Head Loss Curves NSF/ANSI/CAN 50
ANSI/APSP/ICC 16-2017
DIRECTIONS: Please follow the SOFA specific flow rates, sump specifications, and flow path zone information below.
The installation must conform to these minimum/maximum requirements including the SOFA dimension defined in Figure 1.
The flow path zone is defined by dimensions A through E. The installed sump may be manufactured or field-built and it may
be larger/deeper than Figure 1. Please write the Cover Model Number, orientation, and SOFA Model Flow Rating on the
VGBA DRAIN COVER IDENTIFICATION INFORMATION label that comes with each AquaStar Pool Products, Inc. drain cover.
FOR MOST CURRENT INFORMATION
Cover Model Number: FIGURE 1-SOFA MODEL&FLOW PATH SCAN THE OR CODE OR VISIT
1216xxx W .AQUASTARPOQLPRODUCTS.COMIFLOWCODE
/y„y"rr r-L- : PRINTED DOCUMENTS MAY NOT HAVE THE MOST CURRENT FLOW
e/trttit nem Y RATINGS OR INSTALLATION OPTIONS.
I
g-IIIlllll111 !�"�••++. i 1Ttr ;111111111111111111=== �` ,, h1111111111=--"- B. Mnmum Sumpt3epth . ' : IIl1nI6uas==== C Minimum Ledge Depth III11�'•..I. 1®l�Il l•,t,
- �IIIIIIIIlIII�11'i O. Maximum Ledge Width 11 r.I'•,1. .1 • I'1:1.��.llll
```"'''����``''" E. Minimum Pipe Onset !'I,r 1;dl::ll[.''1.;1'-f1 .I lt';gl,u
F. Minimum Length Before Reduction I:l MI'I i1;11�lll'�'l ljl
SOFA Model RI Pipe Size Pipe Depth Orientation Flow Rating Head Loss
(Nominal) (Minimum) (Wall/Floor) (GPM) Curve
1216-12f_A-1.5b_B3_C0.3_DO.7_E3.5_F16 1.5"(b) 3" Floor(f) 126 A
1216-8f A-2s B1.6 CO.4 D0.5 E2.4 F16 2"(s) 1.6" Floor(f) 150 B
1216-9f_A-2b_B3_C1.6_DO.5_E2.8_F16 2"(b) 3" Floor(f) 200 c
1216-8f_A-2.5b B3_C0.4_D0.4_E2.3 F16 2.5"(b) 3" Floor(f) 250 D
1216-9f_A-3b_B3 C1.6_D0.5_E2.5_F16 3"(b) 3" Floor(f) 320 E
1216-9f A-4b 89.8 C1.6 D0.5 E1.8 F16 4"(b) 9.8" Floor(f) 584 F
1216-12f_A-4s_B6_CO.3_D0.7_E3_F16 [Sump P/N 12-3SB] 4"(s) 6" Floor(f) 500_ G _-
1 1216-12f_A-4s,2.5b_B6_C0.3_D0.7_E3_F16 [Sump P/N 12.35B] 4"(s), 2.5" (b) 6" Floor(f) 626 H
1216-12f_A-6b_B10.5_C0.3_DO,7_E3_F16 [Sump P/N 12-65B] 6"(b) 10.5" Floor(f) 720 I
1216-12w_A-1.5b_B3_C0.3_DO.7 E3.5_F16 1.5"(b) 3" Wall(w) 126 J
1216-12w A-2b_B3_C0.3_D0.7_E3.5_F16 2"(b) 3" Wall(w) 150 K
1216-12w A-2.5b_B3_C0.3_D0.7-..E4.7_F16 2.5"(b) 3" Wall(w) 250 L
1216-12w_A-3b_B3_C0.3_D0.7_E4.2_F16 3"(b) 3" Wall(w) 320 M
1216-9w A-4b B9.8 C1.6 D0.5 E1.8 F16 4" (b) 9.8" Wall(w) 400 N
1216-12w A-6b_B10.5_00.3 D0.7_E3_F16 [Sump P/N 12-6SB] 6"(b) 10.5" Well(w) 540 0
Note 1: "SOFA Model No"nomenclature; bottom pipe=(b), sde pipe=(s). See Fig 1 for capital letters A through E
Note 2: Head loss inHg is measured 16 to 24 inches from the finish surface of the pool. Reference Fig 1 dimension F.
1216 Head Loss Curves 1216 Head Loss Curves
Floor Wall
100 10.0
9.0 A T 9.0
A C / 8.0
I 0 7.0 /
8 D. G H K
,,.0 5.0
�f 5.0 i E 5.0 L
a 0 /' 4.0 i
i.0 3.0 M
2.0 I 2.0 N
1.o i.o O
0.0 0.0
0 100 200 300 400 500 600 700 0 100 200 300 400 500 600 700
GPM GPM
0 2021 AquaStar Pool Products.Inc.All rights reserved. 11032021
A C0 CATAWBA COUNTY
/�" � 100A SOUTHWEST BLVD
`� RECEIPT
a>: :,�;<:: NEWTON,NORTH CAROLINA 28658
L) 7 PHONE:828.465.8399
\ Wednesday,April 5, 2023
\8 42 sM www.catawbacountync.gov
PAYOR: Aqua Tech Pool Management
Aqua Tech Pool Management(Frey,Jeffrey)
PAYMENTS
TRANSACTION NUMBER: TRC-61219843-05-04-2023
PAYMENT DATE: 04/05/2023
PAYMENT TYPE: Credit Card
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
04-23-420878 110-580200.663000 Pool Inspection Fee-Seasonal S150.00
TOTAL PAYMENTS: S150.00
FLI-0000074
CASE TYPE: Food&Lodging Institutions WORK CLASS: 50-Seasonal Swimming Pool
SITE ADDRESS: 1154 COUNTRY CLUB RD,NEWTON NC
Owner CATAWBA COUNTRY CLUB, 1154 COUNTRY CLUB RD,HICKORY NC 28658
B:7047786359
Pool Operator AQUA TECH POOL MANAGEMENT,4101-D STUART ANDREW BLVD,CHARLOTTE NC 28217
C:7047786359
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 04/05/2023 15:04 Page 1 of 1