HomeMy WebLinkAboutDays Inn 500094 App 05 11 23 4 ENVIRONMENTAL HEALTH
iatawba County Government Center
r•,,,1 :,,••r h a county 2S Government Drive I P.O. hi 389 I Newton, NC 23653
Phone (828) 465•8210 I Fax: (828) 46S-7216
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Application for Public Swimming Pool Permit
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Name of public swimming pool: �d4gl S .in i I) ,2 C1 S 6 Ci C2L1'1 q
Street address: 11 1 O 4`Gli,Yti'Yt--) A3 C)-1 ALI -. P
�1 n/ (- .- C r l
City: C t'"71O \iQ Y State: +Y L ZIP: L j 1 J
Type of public swimming pool �C Winming pool !Madill pool DSpo []Other (hurt.)
Date constructed or remodeled:ngefore May
M .
I, 1993 a er may I, 1993
1 ' �
Dates of operation: Openingg date: `� Closing date: 0�, -0}33 P )1 Opening
Hours of operation: time: I 1 O O I)m Closing lime: 1 ) :6O 'p ,
Name of owner: CJ ot.1 TO)OP YUYY1 NT KOij r-•L._( Owner email:PN:)Ck 1 0 re 1 Fy' 1c- f yj r
Mailing address: .--110 T c. iyc vP C(-1 A J p r
City: COT\(2\(Y State:NC ZIP: �O 'b 1
Contact Person: n1(Art- 1 Gt.\-- Phone#: C‘ u65 ^�'3 7
•lit- M<'.nagc.i i information , :111 09)C
Pool operator. '\Ct_ \C.lQ,1 Phone#: ��-� U7 ,l ' l 1\ y C,t
Street address: (1 10 1Y in1?' e (9\ d-- SP ff
City: CO Yr 6 vt?-( State:NC ZIP: 2Y b\
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Pool operator trained by: ational Swimming Pool Foundation (Certificate#: NC 2-2-2-1b(9 E
':r+ 12 I^ 11 }
[]Other (please specify)
Application Submitted by: --V1 (`t ea.l-c ❑Owner WOperator
Signature of Applicant: Date: 0 CI "-sue 1 - 2..`-' 2 -'�
Psn pose Gr..,.I StevieI301•2b2 requites ikeCommissionliedthServitestodoplrain warning public swimming pools.ihendesi.ISA LICK IU-1SOO'total Ill.welt..., ro.to 4.41,w..,•ta
for an operation permit fir each public swimming pool.This Iowa is to.kw owners or opaatas Of pNElk twlmmIng pools h opply ht prom**.hep.r.e..:Th.h.1...1........01.4..Inv boom'I et L
rornpkkd by the pool owner or.de-avoided representative tithe owner.The completed.ppiwti.n Is suhrdned to the Ind be.lds dp.rn...l tot duo....to lo.d..h Aa p.Wo s.uo..wwl pool s 1....1.4 h
Ieporatc oppliafion must be completed For each pubic swimming poll (spies:Odglrrd to I.,m.Inhlecd si fill IOW broth d epos t.sd.DI ...I... Moms roow to Iw.sl.l.w....mod J.srwww
Schedule for County/District Health Depactrnents wbidr are putished by Nods Cardin.Divld•n ol Hlsi.rinl R mom cn. Powder:A CID lionot I.e.....y bo•.dual bow atrr.m of i..w..w•.l H...f.
Department offn vironmenl end Natural Rnowcec,1630 Mail Service Center,Raleigh,NC 27699.1632,(Cowie'S7.01.00)
D1f R396I jRrased1/03i • G.iw...•Id N.dh S«wa.S..st..(l.d.:114.0o)
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Pool Drain Safety Compliance Data
I'ERIVIIT CANNOT BE ISSIJEI) IF FORM IS INCOMPLETE
A separate room I.required for each pump mchtlme cinulntnn ict or feature
Saute of Pool .(-1.k3 ID,.
Pump I' ` / /` D
Pump C 1Jenl 11\' Q-ye ,�1C-Model# C�'\ t J"h (lorsepower_._- -. .._.
Oki)
D
\lasinu m Pump I Lttv at highest.peed FRO\l Pt1AMP CURVE: a» epot. Pump use:Circulation/jet/feature(circle one)
I la.PIMP lucn set ked Idt•connected Iinm pxtwcr for any mason)or changed out in Inst 12 months? YES (fp
I I.,tt inter I t.nudat uut� Flow meter Leading
Drain Sump \lcasuremcnts Is drum coversungnless? YES/NO
Sump nt;untlactnct and model OR: Field built sunup(circle if yes)
I balmier id pipe coming sump 21\ inches. Pipe enters thmugh IiOTEOM/SIDE of sump(Must circle one)
Distant e hctt cot highest point of outlet pipe and top edge of sump inches.Sump dimensions
Drain Cover Data -MAST BE INSTALLED PER MANUFACTURER'S INSTRUCTIONS-Attach Instructions in form.
y'll
\ „(nr.nn drains ou each pump 2-- Distance between`main drains tun centers) feet "I inches
'nvrr gtale manufacturer 'Jf O'WIC.t/1'I4— .model T ^P ,VGIIA approval 2008/2017(circle one)
.low;aline hum iinstructions: `2 Rpm Covcr(s)located on pool:Floor/wall(circle one)
)ate installed 0'b^ 01'2°219 Lifespan O 6"01 "2'96 EXPIRATION DATE
+aril der('ot ers
tither in oii,•oibie skimmer ctluali/ers Ilave the equalizers been pctmanently disabled? YES NO
,puali/ci Idling\Innulartuter ,Model .Lifespan
dhhea.l:Odom \Ivtd:rctmer .Model .Date Installed
.ureter nl etptah.cr pipe Cover is located on(circle where mounted):Floor/wall
prali/er fining maximum Ilow lusting gpm.
etpualvct suttee grates installed EXPIRATION DATE:
I►'Vacuum Release System(S\'RS)—Safety Vacuum Release System manufacturer/model#-
Yon tt tII he'opined to demonstrate elli'ctivehtess during pennitting inspection. Date last tested
sum Line('Itoose one
\'u t a.uum line in pool OR Protective cover on vacuum lines installed helitre May I,2010,OR
Sell..lostmg,sell-latching cover designed to be opened with a tool on vacuum lines installed Idler May INS c `
attic of pei son pun Ming this information p\clt. Rig I Phone number: sq2 LI NS -
` -- - - Date pS
r.1 1 2n::Ittr immediate use.
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�F'A • CATAWBA COUNTY
100A SOUTHWEST BLVD
�I
k79NEWTON,NORTH CAROLINA 28658 RECEIPT
���� PHONE: 828.465.8399
►� Thursday,May 11,2023
18 42 sM www.catawbacountync.gov
PAYOR: Days Inn Pool
Days Inn Pool(Patel,Roshan)
PAYMENTS
TRANSACTION NUMBER: TRC-638285 16-1 1-05-2023
PAYMENT DATE: 05/I 1/2023
PAYMENT TYPE: Credit Card
305127099
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
05-23-422514 110-580200-663000 Pool Inspection Fee -Seasonal $150.00
TOTAL PAYMENTS: S150.00
FLI-0001275
CASE TYPE: Food&Lodging Institutions WORK CLASS: 50-Seasonal Swimming Pool
SITE ADDRESS: 1710 FAIRGROVE CHURCH RD SE,CONOVER NC
Manager JAI JALARAM HICKORY,LLC, 1710 FAIRGROVE CHURCH RD,CONOVER NC 28613
F:NONE
OTHER-IMPORTED DAYS INN POOL, 1710 FAIRGROVE CHURCH RD,CONOVER NC 28613
F:NONE NONE
Paid By DAYS INN POOL, 1710 FAIRGROVE CHURCH RD SE,HICKORY NC 28613
**NO PEOPLESOFT ACCOUNT ASSIGNED**
Pool Operator DAYS INN, 1710 FAIRGROVE CHURCH RD SE,HICKORY NC 28613
B:8284652378
receipt 05/11/2023 14:43 Page 1 of 1