HomeMy WebLinkAboutBest Western Permit 500006 05 18 12.JH.pdfN.C. Department of Etwirorm*nt. mid Natural Resources
DivUlon ofEwinturental Health
PUBLIC SWIMMING POOL
OPERATION PERMIT
F;TMU777,0�1N
Identification, Number a 0 1 8 5 0 0 0 0 6
OldFamlity ID (required if
Transitional)
Timelw 1 1 4 Time Out 1 1 ' 4 9 Roam *Date Issued 0 5 / 1 8 a 0 1 a
Totat Time, 1 minute *Status Code:
Please use R[fl[flR]Ufl E]g] 2 R]E]E]R3 Rj@ letters when f fling boxes
Pennission is grwited to:
0 JIWTIIWUMMIRZ�k ff
Owner or Operator of
B E S T W E S T E R N
Name of Public Swimming Pool
to operate apublic swiniming pool as defined in G,S. 130A-280 mid 15A NC AC 18A 2500 at
Address 1 5 .1 0 1 3 T H A V D R S E
City H I C K 0 R Y S T N C zip a 8 6 0 a
C' 0 v tt ty Catawba
Water Supply:
Terrority #-
1654
EHS l.D.#
1-1 -Community
01
—_ EM . A r1riv P R 4 7 • R
Wading Pool - Seasonal
Spa - Seasonal
*Expiration Date: 1 0 / 3 1
Remarks
Waste Water System: 1-1 - Community
bey
Signed Agent
RG, Depatt n -al Rmurces
DiN;isit� of nI M1
.2 0 1 a
N.C. Department of Frrihronmrnt and I-Taturdl Resources 2018500006
Eh -A si o ri o f Frivi rournent-al Health Id Enti fi cati on flumb ef
05/18/2012
PUBLIC SWIMMING POOL Date Issued
OPERATION PERMIT Status Code: I
Permission is grmted to HAMPTON INN of BESTWESTERN
Owner or Operator Name oaf Pij-b;Tc,7wunjnjng Pool
to operate a pub lie swimming pool as defined in G.S. 130A-280 and 15ANCAC 18A. 0 t
TY pe of Pool: (check onJT Swinming Pool
Wading pool
Spa
Other (describe)
Signed: Agent
14, C, D ep ] t 0 a d attu:RPcaources
D'c'r sr on of f
M
Expiration Date: 10,/31/20112
IRMIAINUM
purp()Se: Generat Statute t30A-281 state: "ITo ;mbtic switurrurq pool may be openedfor rase rinlKs the owner (I operator has otvudned
an a)poratloa pennit lnucdby the Dopm-tinent". General Statute 130A-282 roqutroo the Corntnls%ivm for Health Services to
indv4ns reqVivemeoM for vph(ahon reslemi, andvevocaton or quspeAsion c,,fan- oprat qq
perrnit. Those rote: are contained in 15,NCAC 18A 2500,
This E"=l is to b� Usti as the P-=rt sPwlfied alpove,
Preparation: Local errvironrnmtal health szpeQiali;ts $lrall iszuc a permit ev M-r time a new or reismedperrnit is indicated. Prepare an
origirial, arrcl one co-py for:
1, Original given to pool o�-iner or operator.
2, Copy for the local health department
In the event the pernait(tran sitional permit is gusperided or revoked, complete the Su spe.ngiordRevo cation forra (DEUR
4009B),
Di-qpoeition: This foam fnqy be destroyed in accordance vAtli Standard 8,B. &, It spectiou Records, of the Recordo aqposition '70hodulp
published -by the ITC. Division of Arch veg and History,
Ad&bonal burns may be ordered fromDivision of Environmental Health
1632 Mail Service Center
Raleigh, TTC 27699-1632
(Counef 52-01-00)
DRAR 3062 (R wised 7/0 5)
Ewnrauneatal Health Sermces Sedioa(F.-�iewUS)