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HomeMy WebLinkAboutRed Roof Inn 12/31/2002TOWN OF MANSFIELD BOARD OF HEALTH SIX PARK ROANT, 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: Red Roof Inn, Inc. for the operation of a ❑ Public at. Method of water treatment is: Semi -Public 60 Forbes Blvd. Diatomaceous Bathing load not to exceed: 55 bathers ❑ Special Purpose Pool Number of Lifeguards required at all times the pool is open is: None "NO LIFEGUARD ON DUTY" sign is required. Permit No.: 10 Date of Expiration: December 31, 2002 15tv, /W,-� Date Issued Sco e, Health Agent APPENDIX 12 NAME OF CITY OR TOWN STATE SANITARY CODE: CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS, 105 CMR 435.000 I SWIMMING POOL INSPECTION REPORT I TYPE OF POOL: PUBLIC CI q;=hA1-P1 1Q1 ir, Fri-- OMMfIl A I r'll IMMe%elI NAME OF POOLADDRESS ventilation; sanitary condition. OWNER ADDRESS .......................................................................... .................................. ......................•-•--..................... .......................................................................................... DATE OF INSPECTION POOL CAPACITY # OF GALS. .05 Location, structural stability, finish. ................ ....................................... ............................. INSPECTED BY ................................................. ......... ................................. METHOD OF WATER TREATMENT tn1 BATHER LOAD meter reading: _gpm. # of turnovers — ................ .................................................................... # OF LIFEGUARDS WA T SOUR E: �uu ca VIM lvFx &tju-vuv i iiu items marKea Deiow witri an --A-, indicate the violated provisions of 105 CMR 435.000. Items marked with a 'IV " are satisfactory. .03 Bathhouse and sanitary facilities adequate lighting; ventilation; sanitary condition. .............................. ...................................................... .03 Adequate enclosure around pool. Gate self -latching w/ .......................................................................... .................................. ......................•-•--..................... .......................................................................................... ..04 -.S.ew.agq.Pi§p9§p! ..................... .05 Location, structural stability, finish. ................ ....................................... ............................. ....... ................................................. ......... ................................. .06 Water circulation & filtration systems. Filter effluent flow meter reading: _gpm. # of turnovers — ................ .................................................................... ..................... ................................................................................ .06 Suitable automatic equipment for disinfection of pool water. ............................................................................................. .06 Carbon dioxide (CO2) equipment for pH control ........ .............................. .............................................. ............ adequate. CO2 cylinders anchored. Inaccessible to .......................... ......... ................................................................................................... .08 Inlets and outlets - Inlets located to produce uniform circulation. Over rim fill spout 6" above maximum ...)Yat.er. le.vel.... Proi)e.rly.s.hie.1ded..and-.Iocated. .. .. ... Properly . ... ..... .... ............................ ................................. ----------- ......... ----------------- ....................... .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 ...... Bn t NQ rtex. d min. p.coy jdg.d . ....... ................................ .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 plurnbed– . ....................................... _ .... ........ ..... ....................... .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. ................................................................................................................................ .15 Diving equipment in safe condition. ..................................................................................... m bpeaai purpose poop and wading poops equipped wan ................................... .17 Pool supervision -Pool supervision provided. emergency shut off pump switch. Accessible and Ni � .29 Pool water tested with appropriate frequency. ................•--•--......................................................................... prominently marked. ....................•--..........---.......................... ----•--•----....................... ............................................ .............. .21 Permit requirements - Permit issued. Adequate .09 Cross connections. Potable water supplied through air t maintenance and testing records maintained. Records gap. ........ initialed by person making tests. ........................... .31 Waterclarity...................................••-----......................., ..................................................•--•-.................. ................................................... .......... ..................... .10 Skimming facilities. 50% of recirculation drawn from r .32 Water clarity maintenance. Filtration system operating signs posted for special purpose pools. ...... surface of. pool :.................... continuously. ......... ...................................................... .23 Lifeguards required: Yes No ` .12 Line with floats separates non -swimmer area from If lifeguard required; proper credentials, proper suits deeper water. •...............................................................•--.......................--- ........................... ..............................................•--------................... ----................................................ .24 Safety equipment. Ring buoys and rescue hook Rescue tube backboard at .12 Water depth markings on deck and walls. Properly spaced. Boundary line on pool floor and walls. Step Pools. (SPP). provided. and with straps G� edges marked with contrasting colors pools attended by a lifeguard. ................ ....... ...................... .................................... ...................................... b. Thermostatic control only accessible to the pool 13 Walkway and decks 4 feet wide, safe condition. ....... .operator.-.....--•..............•---....------------•-------•-- ............... ..---•........................................................................... .25 Emergency Communication System at the pool and in .14 Ladders, steps - one per 75 feet. Not less than 2 .38 General sanitation. working order. Emergency communication device in ladders. tZ ................................................................................................................................ .15 Diving equipment in safe condition. ..................................................................................... f...... ................................... .17 Pool supervision -Pool supervision provided. *parts per million Effective Jan. 1, 1999, pool supervisor certified as pool' � .29 Pool water tested with appropriate frequency. ................•--•--......................................................................... operator from YMCA or NSPF. .................................•-----------------.....................----- ............................................ .30 Water testing equipment. DPD kit provided for .21 Permit requirements - Permit issued. Adequate chlorine and bromine. Unbreakable thermometer for maintenance and testing records maintained. Records special purpose pools. initialed by person making tests. .31 Waterclarity...................................••-----......................., ..................................................•--•-.................. ........................................................................................................................ .22 Health Regulations: Signs Posted. Health warning .. .32 Water clarity maintenance. Filtration system operating signs posted for special purpose pools. continuously. ......... ...................................................... .23 Lifeguards required: Yes No ` ............ .......... .......................... ............................ .32 Special purpose pool drained, cleaned and every 14 days. If lifeguard required; proper credentials, proper suits and garments worn. Whistle and bullhorn provided. .......................................................-------.....------....--•- Maximum Operating Temperatures for Special Purpose ..............................................•--------................... ----................................................ .24 Safety equipment. Ring buoys and rescue hook Rescue tube backboard at -- Pools. (SPP). provided. and with straps G� .33 a. Thermostatic control provided for each SPP. pools attended by a lifeguard. ................ ....... ...................... .................................... ...................................... b. Thermostatic control only accessible to the pool .25 First aid equipment provided. First aid kit complete ....... .operator.-.....--•..............•---....------------•-------•-- ............... ..---•........................................................................... .25 Emergency Communication System at the pool and in .............................•-----...... .38 General sanitation. 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. .............. ............................. POOLSIDE READINGS Bromine I I r_To__G1 Chlorine IM Free Chlorine Comb. Chlorine pH Level Water Temp. *parts per million � .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 Waterclarity...................................••-----......................., ..................................................•--•-.................. .. .32 Water clarity maintenance. Filtration system operating continuously. ......... ........... ............ .......... .......................... ............................ .32 Special purpose pool drained, cleaned and every 14 days. t .......................................................-------.....------....--•- 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 34 Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF 105 CMR 435.29 THROUGH 435.31. SIGNEDperator I SIGNED Board of HealthiRe-alth Department TOWN OF MANSFIELD, BOARD OF HEALTH SIX PARK ROW, MANSFIELD 02048 SWIMMING POOL APPLICATION Name of Owner: Red Roof Inn, Inc. Address: 14651 Dallas Pkwy. #500 972-702-5987� tpt City: Dallas State: TX Zip: 2,t Telephone: 508-339-2323 Fax: Fed ID/SS No.: Pool Location: 60 Forbes Blvd. Type/pool: Concrete, In -ground Length: 40' Width: 20' Volume: Min/Max. depth: Swim Area: 800sf Dive Area: None Water Source: Town W/W Disposal: Town Sewer Type of Finish: Gunite Scum Gutter: None Deck Type: None Skmmr weir length: Two baskets Treatment System: Diatomaceous Disinfect Method: Automatic Chlorine Chemical Treatment: Manually as required No. of Bathers: 55 Remarks: Per daily testing pool maintained. Permit No.: Fee per pool: $75.00 Permit Expires December 31" yearly SIGNATURE: DATE: Please make appropriate changes. Sign, date and enclose check payable to Town ofMansfield. Mail to: Board of Health, Town ofMansfield, Six Park Row, Mansfield, MA 02048. CAPats Documents\PERMIT APPLICATIOWSWIMMING POOLS APP.doc I certify under the penalties of perjury that I, to my best knowledge and belief, have filed all State tax returns and paid all State taxes required under law. e.s *Signature of Individual or Corporate Name (Mandatory) By: Corporate Officer (Mandatory, if applicable) "Social Security Number (Voluntary) or Federal Identification Number" *This license will not be issued unless the certification clause is signed by the applicant. **Your Social Security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non -filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Mass. General Laws, Chapter 62C, Section 49A.