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Home My WebLink AboutQuail Run HOA App 500049 05 11 23 ENVIRONMENTAL HEALTH Catawba County Government Center catawba county 25 Government Drive ( P.O. Box 389 I Newton, NC 28658 public health Phone: (828) 465-8270 I Fax: (828) 465-8276 001M; HYING NII11Y Email: EHAdministrativeAssisi ints@CatawbaCountyNC.gov Application for Public Swimming Pool Permit P^^' srformatior F �i -t��Z))� Quail Run HOA 1 1) -) Name of public swimming pool: �')`65 LL'L!4`9 Street address: 1050 21st Avenue NW City: Hickory State: NC ZIP: 28601 Type of public swimming pool x Swimming pool Wading pool nSpa Other (describe) Dote constructed or remodeled: Before May I, 1993 After May 1, 1993 Dotes of operation: Opening date: 5/15/2023 Closing date: 9/30/2023 Opening Hours of operation: time: 9am (losing time: 9pm Owner Informatio, Name of owner: Quail Run HOA Owner email: Mailing address: 1 050 21st Avenue NW City: Hickory State: NC ZIP: 28601 Contact Person: Mike Robbins Phone#: 828-312-4393 Operator(On-Site Manager) Information Pool operator: John Paul Knight Phone#: 828-310-5111 Street address: 4418 Granfloral Drive City: Hickory State: NC ZIP: 28601 Pool operator trained by: 7National Swimming Pool Foundation (Certificate#: 68-682019 nOther(please specify) Application Submitted by: John Paul Knight nOwner ?( Operator Signature of Applicant: Dote: Purpose General Statute 130A-282 requires the Commission Health Servicesto adopt rules governing public swimming pools.Therulesin 15.6 NCAC I5A.2500 require the owner or operator to apply annually for an operation permit for each public swimming pool.This form is to allow owners or operators of public swimming pools to apply for permits.Preparation:The information requested on this form is to be completed by the pool owner or a designated representative of the owner.The completed application is submitted to the local health deportment forth,county in which the public swimming pool is located.A separate application must be completed for each pubic swimming pool.Copies:Original to be maintained at the local health department.Disposition:Please refer to Records Retention and Disposition Schedule for County/District Health Departments which are published by North Carolina Division of Historical Resources. Reorder:Additional Forms may be ordered from:Division of Environmental Health, Deportment of Environm ent and Nohrral Resources,1630 Mail Service Center,Raleigh,NC 27699-1632,(Courier 52-01-00) DENR 3961(Revised4/03) Environmental Health Services Section{Review4/06) Pool Drain Safety Compliance Data PERMIT CANNOT BE ISSUED IF FORM IS INCOMPLETE A separate form is required for each pump including circulation,jet or feature. Name of Pool Quail Run HOA 11)#2018500049 I. Pump Flow Jandy VSSHP270DV2A 2.7 Pump Manufacturer Model# Horsepower Maximum Pump Flow at highest speed FROM PUMP CURVE:_ 60 gpm. Pump use 10EMM;et/feature(circle one) Has pump been serviced(disconnected from power for any reason)or changed out in last 12 months?410 NO Flow meter manufacturer Blue & White Industries Flow meter reading GPM 2. Drain Sump Measurements Is drain cover sumpless? YES/NO(if Yes,proceed to section#3) Sump manufacturer and model Hayward OR: Field built sump(circle if yes) Diameter of pipe entering sump 2" inches. Pipe enters through BOTTOM/d, sump(Must circle one) II Distance between highest point of outlet pipe and top edge of sump 3_ inches.Sump dimensions $ii 3. Drain Cover Data—MUST BE INSTALLED PER MANUFACTURER'S INSTRUCTIONS-Attach Instructions to form. Number of main drains on each pump 1 Distance between main drains(on centers) 6 feet •5 inches Cover/grate manufacturer Hayward ,model WG1032 VGBA approval 2008/2017(circle one) Flow rating from instructions 256 gpm Cover(s)located on pool:Floor'wall(circle one) Date installed 5-17-2019 Lifespan 5 yrs EXPIRATION DATE 5-17-2024 4. Equalizer Covers Number of operable skimmer equalizers ._ Have the equalizers been permanently disabled? YES/NO Equalizer fitting Manufacturer n/a ,Model ,Lifespan Bulkhead adaptor Manufacturer n/a .Model ,Date Installed Diameter of equalizer pipe n/a Cover is located on(circle where mounted): Floor wall Equalizer fitting maximum flow rating n/a gpm. Date equalizer cover/grates installed n/a EXPIRATION DATE: 5. Safety Vacuum Release System(SVRS)—Safety Vacuum Release System manufacturer/model#- SURS 1-ADJ-Vacless You will be required to demonstrate effectiveness during permitting inspection.Date last tested r—�/3/20023 6. m Line Choose One No vacuum line in pool OR FTProtective 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 I,2010 Full name of person providing this information John Paul Knight Signature Date NCDHHS Revised 4/1/2022 for immediate use. CATAWBA COUNTY �/ T 100A SOUTHWEST BLVD MILNEWTON,NORTH CAROLINA 28658 RECEIPT V PHONE:828.465.8399 Thursday, May 11, 2023 18 4 2 sM www.catawbacountync.gov PAYOR: Knight Brothers Holding LLC Knight Brothers Holding LLC(Knight,John Paul) PAYMENTS TRANSACTION NUMBER: TRC-63821441-1 1-05-2023 PAYMENT DATE: 05/11/2023 PAYMENT TYPE: Check 1055 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-23-422498 110-580200-663000 Pool Inspection Fee-Seasonal $150.00 TOTAL PAYMENTS: $I50.00 FLI-0000146 CASE TYPE: Food&Lodging Institutions WORK CLASS: 50-Seasonal Swimming Pool SITE ADDRESS: 1050 21STAV NW,HICKORY NC Owner QUAIL RUN HOMEOWNERS ASSOC.INC, 1050 21ST AV NW APT 101,HICKORY NC 28601 B:8283I24393 Pool Operator KNIGHT BROTHERS HOLDING LLC,4418 GRANFLORAL DR,I IICKORY NC 28602 C:8283105I11 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 05/11/2023 13:22 Page I of I