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Home My WebLink AboutCanoe River CG 12/31/2005TOWN 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 emi-Public ❑ Special Purpose Pool at: 137 Mill St. Method of water treatment is: Automatic Bathing load not to exceed: 94 bathers Number of Lifeguards required at all times the pool is open is: None "NO LIFEGUARD ON DUTY" sign is required. Permit No.: 1 Date of Expiration: December 31, 2005 Scott Leit , alth Agent AL)(Ve K" Date Issued � '� � ',� 1 ill � �• 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: 137 Mill St. Type/pool: Cement Length: 57' Width: 30' Volume: 60,000 Min/Max. depth: 3'-10' Swim Area: 57'x30' Dive Area: None Water Source: Town W/W Disposal: Private Leach Type of Finish: Cement Scum Gutter: Deck Type: Cement Skmmr weir length: 4 Treatment System: Sand Disinfect Method: Chlorine Chemical Treatment: Automatic No. of Bathers: 94 Remarks: Permit No.:l 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. RAHealth\Pafs Doc ments\PERMIT APPLICATIONS\SWIMMING POOLS APP.doc 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 ❑ Special Purpose Pool p at: 137 Mill St. Method of water treatment is: Automatic Bathing load not to exceed: 94 bathers Number of Lifeguards required at all times the pool is open is: None "NO LIFEGUARD ON DUTY" sign is required. Permit No.: 2 Date of Expiration: December 31, 2005 Scott L 'e Health Agent Dae Issued Name of Owner Address: City: State: MA Telephone: Fax: Fed ID/SS No.: Pool Location: Type/pool: Length: 40' Min/Max. depth Swim Area: Dive Area: Water Source: W/W Disposal: Type of Finish: Scum Gutter: I kyl1 ►11' 1 Canoe River Campground 137 Mill St. Mansfield Zip:02048 508-339-6462 508-339-5237 04-2375571 137 Mill St. Cement Width: 22' 3' 40'x22' None Town Private Leach Cement None Deck Type: Cement Skmmr weir length: 2 Treatment System: Sand Disinfect Method: Chlorine Chemical Treatment: Automatic No. of Bathers: 94 Remarks: Permit No.:2 Fee per pool: $75.00 Volume: 22,440 Permit Expires December 31" yearly SIGNATURE: DATE: / A i A, L; f JA N 2 005 ft { Please make appropriate changes. Sign, date and enclose check -payable to Town ofMansfreld Mail to: Board of Health, Town ofMansfreld, Six Park Row, Mansfield, MA 02048. R:\Health\PaPs Documents\PERMIT APPLICATIONSMVIMMING POOLS APP.doc NAME OF CITY OR TOWN STATE SANITARY CODE : CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS, 105 CMR 435.000 SWIMMING POOL INSPECTION REPORT TYPF 77 7777 PT TRT .TC nCF.MT-PT TRT .TC` I SPF.C'.TAT . PT TRP0gR P001. rl NAME OF POOL - ADDRESS OWNER ADDRESS DATE I POOL ACITY®I �, INSPECTED BY q INS ECOTION # OF GALSF METHOD OF WATER BATHER / �f #OF IFEGUARDS WATER SOURCE; TREATMENT LOAD Regulation 105 CMR 435.000 The items marked below with an "X" indicate the violated provisions of 105 CMR 435.000. Items marked with a "✓' are satisfactory. I REGULATION X/✓ VIOLATIONS/COMMENTS I ventilation; sanitary condition. .03 Adequate enclosure around pool. Gate self -latching w/ latch 4 ft above ground. .04 Sewage Disposal .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 public, adequate ventilation provided. .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 the use of tools. Open area does not provide entrapment of fingers, toes, etc. At least one antivortex drain provided. .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 .08 Special purpose pool and wading pools equipped with emergency shut off pump switch. Accessible and prominently marked. .09 Cross connections. Portable 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 I Other ladders. .15 Diving equipment in safe condition. 1/110 .17 Pool supervision - Pool supervision provided. chlorine and bromine. Unbreakable thermometer for Effective Jan. 1, 1999, pool supervisor certified as pool special purpose pools. operator from YMCA or NSPF. .31 Water clarity .21 Permit requirements - Permit issued. Adequate .32 Water clarity maintenance. Filtration system operating maintenance and testing records maintained. Records continuously. initialed by person making tests. .32 Special purpose pool drained, cleaned and every 14� .22 Health regulations: Signs posted. Health warning days. signs posted for special purpose pools. / Maximum Operating Temperatures for Special Purpose .23 Lifeguards required: Yes ❑ No Pools. (SPP). If lifeguards required. Proper credentials, proper suits .33 a. Thermostatic control provided for each SPP. and garments wom. Whistle and bullhorn provided b. Thermostatic control only accessible to the pool .24 Safety equipment. Ring buoys and rescue hook operator provided. Rescue tube and backboard with straps at .38 General sanitation pools attended by a lifeguard. .25 First Aid equipment provided. .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 ]Bromine 2;0=6 0 "o pi I I Total Chlorine +✓ Alkalinity50=1$Q, m Free Chlorine Cyanuric Acid (30-.10Q ppiii) ,. Comb. Water *parts per million I .29 Pool water tested with appropriate frequency. I Other .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). I" .33 a. Thermostatic control provided for each SPP. b. Thermostatic control only accessible to the pool operator .38 General sanitation Vf REGULATION NO. I THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE .34I I Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF 105 CMR 435.29 THROUGH 435.31. SIGNED (SIGNED Operator Board of Health/Health Department P^/�F1zF NAME OF CITY OR TOWN STATE SANITARY CODE : CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS, 105 CMR 435.000 SWIMMING POOL INSPECTION REPORT TYPE nF PonF Pi mi .ir n cr~ r,Ir_nr TnT ro QDL 117 AT DT mD^a» Dt1llT n NAME OF POOL % ADDRESS - - --- - MCLS 137 OWNER ADDRESS DATE OF INSPECTION ��sj�Q POOL CAPACITY �2 INSPECTED BY �� # OF GALS j 16& % METHOD OFWATER TREATMENT BATHER /; "! # OF LIFEGUARDS WATER SOURCE; LOAD Meguiarion iva %-'v' is 4Ja.uuv I ne Items marKed below with an "X" indicate the violated provisions of 105 CMR 435.000. Items marked with a "✓" are satisfactorv. I REGULATION X/✓ VIOLATIONS/COMMENTS ventilation; sanitary condition. - .03 Adequate enclosure around pool. Gate self -latching w/ latch 4 ft above ground. .04 Sewage Disposal .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 public, adequate ventilation provided. 08 Inlets and outlets - Inlets located to produce uniform circulation. Over rim fill spout 6" above maximum water level. Properly shielded and located. I V 08 Main drain suction outlets covered with suitable protective covers or grates. Cannot be removed without the use of tools. Open area does not provide entrapment of fingers, toes, etc, At least one V antivortex drain provided. .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 .08 Special purpose pool and wading pools equipped with emergency shut off pump switch. Accessible and prominently marked. .09 Cross connections. Portable 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 0 No Q/ If lifeguards 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. .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 S 0 Alkalin 50-15,0 m __ Free Chlorine 1.0=3.0 Cyanuric Acid '(30-100 ppm) Comb. (U:0-0.2 ppm) Water Temp. 1049l H level (7.2-7.8) *parts per million I 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 I M NO. I THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE .34I ( Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF 105 CMR 435.29 THROUGH 435.31. SIGNED (SIGNED Operator Board of Health/Health Department