Loading...
HomeMy WebLinkAboutHickory Inn/Mainstay 500107 App 05 24 23.itf ENVIRONMENTAL HEALTH Catawba County Government Center 25 Government Drive I P.O. Box 389 I Newton, NC 28658 Phone: (828) 465-8270 I Fax: (828) 465-8276 catawba county public heat! Email:EHAdministrativeAssistants@CatawbaCountyNC.gov r,—ll,t ilhh.IOW Application for Public Swimming Pool Permit r`_ 15q90/ Pool Information \T - or 5oz on Name of public swimming pool: Comfort Inn 1 Mainstay Suites Street address: 1607 Fairgrove church rd City: Conover State: NC ZIP: 28613 Type of public swimming pool : Hospitality Swimming pool Date constructed or remodeled: I believe May 1, 1993 Dates of operation: Opening date: 5/25/2023 Closing date: 9/30/2023 Hours of operation: Opening 11 AM Closing time: 10PM NCit":,� !>,k35.8276 Owner Informatiul Name of owner: Ravi Patel Owner email: ComfortMainstay1607@gmail.com Mailing address: 1607 Fairgrove church rd City: Conover State: NC ZIP:28613 Contact Person: Ravi Patel Phone #: 9105364510 Opt:r: for (Oft-Sitc ithimage,r) information Pool operator: Ravi Patel Phone #: 9105364510 Street address: 1607 Fairgrove Church Rd City:Conover State: NC ZIP: 28613 Pool operator trained by: Terri Stroupe National.Swimming Pool Foundation (Certificate #: glavykg) Application Submitted by: Ravi Patel Owner Operator ,Ig d;:ttr-:: /3012tk23 Signature of Applicant: Date: , 5`/ .2-lz3 b;.cf,fn City: Conovei NC ZIP:28613 PurposeGeneralStatuts130A-282requires theCommiesionHealthServicestoadoptrules governing pubilcswimmingpools.Therulesin 16A NCAC 1SA.2500 require the owner or operator to apply annually for an operationpermit for sachpubllc swimming pool.This form Is to allow ownersor operatorsofpublic swimming pools to applyfor permits. Preparation; The information on submitted o thle localm health department epartm ent orthocounty or a designatedpublic representative o`lIs located. Aowner. s completed separate application must be completed for each public s swimming pool. es in which te maintained swimming p swimming poaL Copies: Original to be malnlalned at the local health department Disposition: Please refer.t4 Records Ratentlonand Disposition Schedule for CountylOistrict Health Departments which are published by North Carolina Division of Historical Resources. Reorder.Additional Forms may be ordered from: Division of Environmental Health, DepartmentofEnvironmerrtand Natural Resources, 1630Mail Service Canter,Raleigh,NC 27699-1632,(Courier 52-01-00) DENR 3961(Revlscd4103)EnvlronmentalHealthSsrvlcesSection(Review4106) + ._....e...............la thwrillwsir. 5 c. • 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 Comfort Inn / Mainstay Suites ID# £r2�-�-'DQ 4 o qy�, 1. Punta Flow � � - 1! Horsepower 5 Pump Manufacturer— Model# Maximum Pump Flow at highest speed FROM PUMP CURVE: gpm. Pump use:Circulation/jet/feature(circle one) lies pump been serviced(disconnected from power for any reason)or changed out In last 12 months? YES/NO Flow meter manufacturer Flow meter reading GPM 2. Drain Sumn Measurements Is drain cover sumpless? YES/NO(if Yes,proceed to section#3) Sump manufacturer and model Sump less OR: Field built sump(circle if yes) Diameter of pipe entering sump inches. Pipe enters through BOTTOM/SIDE of sump(Must circle one) Distance between highest point of outlet pipe and top edge of sump inches.Sump dimensions 3. grain Cover Data-MUST BE INSTALLED PER MANUFACTURER'S INSTRI.iCTIONS-Attach Instructioes to form. Number of main drains on each pump 2 Distance between main drains(on centers) 10 feet inches Cover/grate manufacturer Waterway ,model 640-4720 V ,VGBA approval 2008/2017(circle one) 356 Maximum flow rating of cover/gra1 1 3 gpm Cover(s)located on pool:Floor/wall(circle one) Date installed 7/20/2021 Lifespan 7 Years EXPIRATION DATE 7/20/2028 4. Equslizer Covers Number of operable skimmer equalizers 0 Have the equalizers been permanently disabled? 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. Auto Filling System Date equalizer cover/grates installed EXPIRATION DATE: 5. Safety Vacuum Release System(SVRSI-Safety Vacuum Release System manufacturer/model#- You will be required to demonstrate effectiveness during permitting inspection.Date last tested 6. .1! , Choose One CANo vacuum line in pool ORProtective cover on vacuum lines installed before May 1,2010,OR 111 Self•closin self-latching cover resigned to be opened with a tool on vacuum lines installed after May 1,2010 Full name of person providing this information Ravi Patel 1. Signature ° fr‘ Date S7 2043 NCDHHS Revised 1/27/2022 for immediate use. Waterway Technical Bulletin:VGB2008 (5 41) VGB 2008 b40-472X V 12"x 12"Grate and Frame + u`,11 '• 1 { '{Aa xwq; 7 640-4720V Waterway grates and frames are compliant with the Virginia Graeme-Baker Itt.-:;,. . ,.• `` �;' ViiA III`` \\\‘� \y ' .. Pool and Spa Safety Act(ASME/ANSI A112.19,8-2007)and are UL Certified. 11e ��'� ;��� \ They are designed for single or multiple drain use.This grate assembly Y � �� ° .\ includes frame and stainless steel screws.Packed 6 per case. \64\, k 711* \\*t\ l' -' At\ , k. i%N '" . -' * The Waterway 640-472x V series grates and frames are available in: ❑ White IN Black ® Gray ■ Dark Gray ■ Beige 10 ro,..), ....„...-. Model No. Description Size Total Open Area Floor Flow Rate Wall Flow Rate Flow Rate GPM Squa,e Inches GPM GPM a 1.5(1'sc_ 640-472x V Grate 12"x 12" 62.4 356 ire,1.83 ft/sec 280 chi 1.44 ft/sec 292 13250 - --11.782 Pork,. Description 819-1031 #8 x 1 Stainless Steel Screw !1 I .t 642-472xV 12"x12"Pool Grate : , , 11T0 I. • i 1 642.473x 12"x 12"Grate Frame •.' i II ii . ► IMO -I=i i.�` l I it 4 1 1 6 1'Uiii II ► i 1' Jw 11 81 11. �u -I�II /l11L11lII , -u .... - .,Illli.i0I .� 1 b •111111 IIiiII :ill, .1 P .i 1, I11782 642.472xV— 1 i 1 11.100 13.250 _.Qi� I. . u i� q . = `�� t I. I. . b !iIl����l •. �\� \. II it —I iii- - •ll . ` i ;•�" ! 642-473aV u LLEW u \\\i N/ AiC 10 1D I'� 11�� L � .��1tl�I. ,�. Ems• _..1�I�' -��. � 1 L.,9,1 1253 Opening between ribs /-.IM_ .266 M-,1! . 1j. Made in ,_jig the USA moo' M Emommomm ©2011 Waterway Plastics 2200 Sturgis Road,Oxnard,CA 93030•Ph.805-981-0262'waterway@waterwayplastics.com•www.waterwayplastics.com 807-0083.1011 a • • • • C Total Dynamic Head In Feet Of Water a. 0 0 0 0 ' o s g $ 8 i n co o 0 0 �, .� 0 :11' 0 O II II fD II ii D + • C c 3 . (04,111-4":"*"6.-- IRcr -1114 CI T r71 CIfDrt cu vi vi IP. § M v = 5 I m r-► 4 r 1 rc, m o , MI 0 I & , I, i - ,,`,' ,yS1A ♦ CATAWBA COUNTY 100A SOUTI(WEST BLVD f NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE:828.465.8399 Wednesday,May 24,2023 www.catawbacountync.gov PAYOR: Hickory Inn Hickory Inn(Patel,Ravi) PAYMENTS TRANSACTION NUMBER: TRC-64754107-24-05-2023 PAYMENT DATE: 05/24/2023 PAYMENT TYPE: Credit Card INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-23-423125 I io-58o200-663000 Pool Inspection Fee-Seasonal $150.00 TOTAL PAYMENTS: $150.00 FLI-07-2021-154926 CASE TYPE: Food&Lodging Institutions WORK CLASS: 50-Seasonal Swimming Pool SITE ADDRESS: 1607 FAIRGROVE CHURCH RI)SE,CONOVER NC 28613 Applicant HICKORY INN, 1607 FAIRGROVE CHURCH RD SE,CONOVER NC 28613 B:8284651100 '•NO PEOPLESOFT ACCOUNT ASSIGNED rr receipt 05/24/2023 10:06 Page 1 of 1