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Home My WebLink AboutCanoe River CG 12/31/2001TOWN OF MANSFIELD BOARD OF HEALTH SIX PARK ROW, MANSFIELD 02048 PERMIT TO OPERATE A SWIMMING POOL In accordance with the proWsions of Chapter 111, Section 127A of the Massachusetts General Laws, and Regulations established by the Massachusetts Department of Public Health (105 CMR 433.00), permit is hereby issued to: Canoe River Campground for the operation of a fJ Public, f Semi -Public or fJ Special Purpose Pool at: 137 Mill St. Method of water treatment is: Sand Bathing load not to exceed 94 bathers. Numher of Lifeguards requiredal all times the pool is open is None. "NO LIFEGUARD ON DUTY" sign is required Permit No.: 1 Date of Expiration: December 31, 2001 f'h✓�79 � Zz� DateeIIssued cott Leite, Health Agent TOWN OF MANSFIELD, SIX PARK ROW, MANSFIELD 02048 SWIMMING POOL APPLICATION Name of Owner: Canoe River Campground Address: 137 Mill St. City: Mansfield State: MA Zip: 02048 Telephone: 508-339-6462 Fax: 508-339-5237 Fed ID/SS No.: 04-2375571 Pool Location: Type/pool: Length: Min/Max depth: Swim area: Dive area: Water source: W/W Disposal: Type of finish: Scum gutter: Deck type: Skmmr weir lgth Treatment systm Disinfct method: Chemical trtmnt: No. of Bathers: Remarks: Permit No: Fee: $75. 137 Mill St. Cement 57' Width: 00 3'-10' 57'x30' None Town Private Leach Cement 1 Cement 4 Sand Chlorine Automatic 30' Volume: 60,000 gals Please review information and make any applicable changes. Return to BOH office at above address with check payable to town of Mansfield, $75.00 each pool. Permit expires December 31 st yearly. Thank you. i Date TOWN OF MANSFIELD BOARD OF HEALTH SIX PARK ROW, MANSFIELD 02048 PERMIT TO OPERATE A SWIMMING POOL In accordance with the provisions of Chapter 111, Section 127A of the Massachusetts General Laws, and Regulations established by the Massachusetts Department of Public Health (105 CMR 435.00), permit is hereby issued to: Canoe River Campground for the operation of a [] Public, Semi -Public or [] Special Purpose Pool at: 137 Mill St. Method of water treatment is: Sand Bathing load not to exceed 94 bathers. Number of Lifeguards required at all limes the pool i.s open is None. "NO LIFEGUARD ON DUTY" sign is required Permit No.: 2 Date of Expiration: December 31, 2001 fvi-�L� J Date Issued Scdtt Leite, Health Agent TOWN OF MANSFIELD, SIX• ROW, MANSFIELD 02048 SWIMMING 1 ;1 Name of Owner: Canoe River Campground Address: 137 Mill St. City' Mansfield 1 1, 22' Volume: 12,000 gals Please review information and make any applicable changes. Return to BOH office at above address with check payable to town of Mansfield, $75.00 each pool. Permit expires December 31 st yearly. Thank you. Date State: MA Zip: Telephone: 508-339-6462 Fax: 508-339-5237 Fed ID/SS No.: 04-2375571 Pool Location: 137 Mill St. Type/pool: Cement Length: 40' Width: Min/Max depth: 3' Swim area: 40'x22' Dive area: None Water source: Town W/W Disposal: Private Leach Type of finish: Cement Scum gutter: Deck type: Cement Skmmr weir lgth: 2 Treatment systm: Sand Disinfct method: Chlorine Chemical trtmnt: Automatic No. of Bathers: 94 Remarks: Permit No: 2 Fee: $75.00 1 1, 22' Volume: 12,000 gals Please review information and make any applicable changes. Return to BOH office at above address with check payable to town of Mansfield, $75.00 each pool. Permit expires December 31 st yearly. Thank you. Date APPENDIX 12 NAME OF CITY OR TOWN STATE SANITARY CODE: CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS 105 CMR 435.000 SWIMMING POOL INSPECTION REPORT TV[Dr- OP Pr)r)l - P1 IRI IC' n SEMI-PUBLIC SPECIAL PURPOSE POOL NAME OF POOL ff, ADDRESS OWNER ADDRESS DATE OF POOL CAPACITY INSPECTED BY INSPECTION # OF GALS. L;&j ta�=- METHOD OF WATER BATHER # OF LIFEGUARDS WATER SOUR E: ITREATMENT LOAD -Z Ann fIR Ar') A 13C nfN1 Regulation 105 GIVIR 435.000 ine items marKea Ue1QW WIL111 di I A IIIUIICIVc L It; V1kJI0LUU VI�V--- -1 Items marked with a V " are satisfactory. athhouse and sanitary facilities adequate lighting; ventilation; sanitary condition. ........................ ................................ I .................... ........ ...... .03 Adequate enclosure around pool. Gate self -latching w/ i ................................. .............. ... ...... .04. Sewagf�.Di.Spq§p! ................ .......... - ......................... .... ..... ........ .05 Location, structural stability, finish. .... ............................. .............................................. ............ .06 Water circulation & filtration systems. Filter effluent flow meter reading:1 4r) _gpm. # of turnovers— ............................. 7-7�...:: ....................... ....... ............... ........ .06 Suitable automatic equipment for disinfection of pool water. .................................. ................... ------ ----------------- - ............ ...... .06 Carbon dioxide (CO2) equipment for pH control adequate. CO2 cylinders anchored. Inaccessible to /Lo p.vbli.Q..a.d.eqv.ale.v.entijateQn.p.cQyid.e.d .................................... ..... .08 Inlets and outlets - Inlets located to produce uniform circulation. Over rim fill spout 6" above maximum ....... water level. Properly -located..-... . .............. .............. ..... . . ... ... . .. . ... ..... .08 Main drain suction outlets covered with suitable protective covers or grates. Cannot be removed without use of tools. Open area does not provide entrapment of fingers, toes, etc. At least one ....... antNQrtex.drain.prQyid.ed ............................................ .............. .08 Each system outlet protected against user entrapment by antivortex cover or other means. Minimum of 2 suction outlets provided for each pump, properly located and .plumbed_.. _........................ ................... ..... . .08 Suction outlet covers in place, unbroken and secure and cannot be removed except with the use of tools. Close pool immediately if outlet covers missing, broken , loose or can be removed without tools until repairs are made. ZV&pecial purpose poo an wa ing pools equipped with emergency shut off pump switch. Accessible and prominently marked. ................................................. .............................. .09 Cross connections. Potable water supplied through air gap. .................................................................................. .10 Skimming facilities. 50% of recirculation drawn from ..... surface of pool: .12 Line with floats separates non -swimmer area from deeper water. ............................................................... .............. .12 Water depth markings on deck and walls. Properly spaced. Boundary line on pool floor and walls. Step edges marked with contrasting color. ........................................................ .... ...... .13 Walkway and decks 4 feet wide, safe condition. .14 Ladders, steps - one per 75 feet. Not less than 2 ladders. .......................................... .......... ..... .... .15 Diving equipment in safe condition. .17 Pool supervision - Pool supervision provided. Effective Jan. 1, 1999, pool supervisor certified as pool operator from YMCA or NSPF. ...................................................... .... ................... .21 Permit requirements - Permit issued. Adequate maintenance and testing records maintained. Records initialed by person making tests. ............................................................. _....... _........ .22 Health Regulations: Signs Posted. Health warning signs posted for special purpose pools. ........................................ .. ............ .23 Lifeguards required: Yes No If lifeguard required; proper credentials, proper suits and garments worn. Whistle and bullhorn provided. .................................................. _..... ........ _..... .24 Safety equipment. Ring buoys and rescue hook provided. Rescue tube and backboard with straps at pools attended by a lifeguard. .25 First aid equipment provided. First aid kit complete ................................................... .25 Emergency Communication System at the pool and in working order. Emergency communication device in unlocked area and available at all times to staff and the public. Operating instructions and emergency numbers posted. ...................................................................... ............ .26 Waste and backwash water disposal properly discharged. No direct connection to sewer system. Separation tank provided for diatomaceous earth filter backwash water. .......... ..... .................. •. ..............._.. .... .29 Chemical standards. I� POOLSIDE READINGS Bromine Total Chlorine Alkalinity (5Q, 150, Al}' •. Free Chlorine Cyanuric Acid (�Q:"(i�0 ;' Comb. Chlorine Q00ft,� Water Temp. vel *parts per million Other .29 Pool water tested with appropriate frequency. ................................................................... ............. .30 Water testing equipment. DPD kit provided for chlorine and bromine. Unbreakable thermometer for special purpose pools. ......................... ........................................................... .31 Water clarity..... ............ ......... ... ........... ............. ..... .32 Water clarity maintenance. Filtration system operating continuously. ................... - .... .32 Special purpose pool drained, cleaned and every 14 days. ------------------------ .................................................... . Maximum Operating Temperatures for Special Purpose Pools. (SPP). .33 a. Thermostatic control provided for each SPP. b. Thermostatic control only accessible to the pool .......... operator ..................................................... .... .... 38 General sanitation. REGULATION NO. I THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE sa Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF 105 CMR 435.29 THROUGH 435.31. SIGNED SIGNED Aerator Board of HealthiHealthDepartment APPENDIX 12 i2au/ NAME OF CITY OR VOWN STATE SANITARY CODE: CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS 105 CMR 435.000 SWIMMING POOL INSPECTION REPORT TYPE OF POOL: PUBLIC ❑ SEMI-PUBLIC ❑,, SPECIAL PURPOSE POOL . NAME OF POOL 2•ADDR $S r� lUli --' s ` OWNER ADDRESS DATE OF POOL CAPACITY INSPECTED BY INSPECTION `? C, # OF GALS. 2` METHOD OF WATER BATHER # OF LIFEGUARDS WATER SOURCE: TREATMENT LOAD Regulation 105 CMR 435.000 The items marked below with an "X" indicate the violated provisions of 105 CMR 435.00 Items marked with a V" are satisfactory. Xl✓ at i ouse and sanitary facilities adequate lighting; ventilation; sanitary condition. .................... .............................. ........................................................... ..................... .03 Adequate enclosure around pool. Gate self -latching w/ _.latGh_4 ft.ab9ve.gr4Und................................................ ................................................ ................. ....................................... .04. Sewage.Disposal................................_..................... .......---................._................................---------...__................ .05 Location, structural stability, finish. .06 Water circulation &,fi#tration systems. Filter effluent flow meter reading: 1 gpm. # of turnovers_ } ......................................... ........................ . ...................................1... ... .06 Suitable automatic equipment for disinfection of pool water. ........._......................._................._.... ...._....................................._... .06 Carbon dioxide (CO2) equipment for pH control adequate. CO2 cylinders anchored. Inaccessible to public,.adequate.venti)ation.proxided............................ ....... - .08 Inlets and outlets - Inlets located to produce uniform circulation. Over rim fill spout 6" above maximum water level. Properly shielded and located...... _........ _... ................_.......... -- ........................................... .08 Main drain suction outlets covered with suitable protective covers or grates. Cannot be removed without use of tools. Open area does not provide oe entrapment of fingers, toes, etc. At least one ....... antivortex.drain-P-Mided.............. .............................. ......................................... ............_..._..._......._.................... .08 Each system outlet protected against user entrapment by antivortex cover or other means. Minimum of 2 oe suction outlets provided for each pump, properly ...... located and .plumbed ................................................. ......... ...._........._............ _..._.. .08 Suction outlet covers in place, unbroken and secure and cannot be removed except with the use of tools. Close pool immediately if outlet covers missing, broken , loose or can be removed without tools U4 until repairs are made. ag-S—pecial purpose pool and wading pools equipped wim emergency shut off pump switch. Accessible and prominently marked. 09 Cross connections. Potable water supplied through air gap.......... ................. 10 Skimming facilities. 50% of recirculation drawn from surface ofpool: ....- - _ ..................I.................. .................... ....._.............. 12 Line with floats separates non -swimmer area from deeper water. ................ .............._............_ 12 Water depth markings on deck and walls. Properly Step spaced. Boundary line on pool floor and walls. edges marked with contrasting color. ............................... ......_- ......--- -- .............. ..................................... .13 Walkway and decks 4 feet wide, safe condition. .................. ..... ....................... ............ ... ____ ...................... .14 Ladders, steps - one per 75 feet. Not less than 2 ladders. .15 Diving equipment i.. safe condition. �A Pool supervision - Pool supervision provided. .17 Effective Jan. 1, 1999, pool supervisor certified as pool operator from YMCA or NSPF. .................. .----------- ............. .... .. .......................... .21 Permit requirements - Permit issued. Adequate maintenance and testing records maintained. Records initialed by person making tests. ...................__ ............................ ............................__...................... .22 Health Regulations: Signs Posted. Health warning signs posted for special purpose pools. 23 Lifeguards required: Yes No If lifeguard required; proper credentials, proper suits and garments worn. Whistle and bullhorn provided. 24 Safety equipment. Ring buoys and rescue hook provided. Rescue tube and backboard with straps at pools attended by a lifeguard. .25 First aid equipment provided. First aid kit complete ....................................................................... .25 Emergency Communication System at the pool and in working order. Emergency communication device in unlocked area and available at all times to staff and the public. Operating instructions and emergency numbers posted. ..................... .................._............................................................._......... Waste and backwash water disposal properly .26 discharged. No direct connection to sewer system. Separation tank provided for diatomaceous earth filter backwash water. ........................ ................................................... .29 Chemical standards. POOLSIDE READINGS Bromine (2 Q -. ¢;0 qpm;-) Total Chlorine Alkalinity (60 Free Free Chlorine Cyanuric Acidti''1OQ ' flit' Comb. Chlorine Water Temp. AbE. pH Level "parts per million Other .29 Pool water tested with appropriate frequency. .......... ............................. ............--- ......... .. Water testing equipment. DPD kit provided for .30 chlorine and bromine. Unbreakable thermometer for special purpose pools. :31 Water clarity, ... _.... ._.. ..............................._......................_... .32 Water clarity maintenance. Filtration system operating continuously. _..__............._.__... --------- ----- ..................... .32 Special purpose pool drained, cleaned and every 14 days. ..................... ........................... Maximum Operating Temperatures for Special Purpose Pools. (SPP). a. Thermostatic control provided for each SPP. .33 b. Thermostatic control only accessible to the pool ...... .operator.- ........ -..... .38 General sanitation. REGULATION NO. THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE J 34 Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF 105 CMR 435.29 THROUGH 435.31. SIGNED Aerator I SIGNED Board o ealt ealth epartment