HomeMy WebLinkAboutMansfield Children's C. 12/31/2005TOWN OF MANSFIELD
BOARD OF HEALTH
IX 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:
Mansfield Children's Ctr.
for the operation of a ❑ Public 0,9emi-Public ❑ Special Purpose Pool
at:
1100 School Street
Method of water treatment is:
Bathing load not to exceed: 43 bathers
Number of Lifeguards required at all times the pool is open is: None
"NO LIFEGUARD ON DUTY" sign is required.
Permit No.: 8
Date of Expiration: December 31, 2005
6v ----
Scott LeitV Health Agent
Date Issued
Name of Owner:
Address:
City:
State: MA
Telephone:
Fax:
Fed ID/SS No.:
Pool Location:
Type/pool:
Length: 41'
Min/Max. depth:
Swim Area:
Dive Area:
Water Source:
W/W Disposal:
Type of Finish:
Scum Gutter:
Deck Type:
Skmmr weir length:
Treatment System:
Disinfect Method:
Chemical Treatment:
No. of Bathers:
Remarks:
Permit No.:8
Fee per pool:
SIGNATURE:
DATE:
� 1 1 '11, ►,, 1 .
Mansfield Children's Ctr.
1100 School Street
Mansfield
Zip:02048
508-339-9211
1100 School Street
Semi -Public
Width: 21' Volume:
3.5' to 6'
400sf
None
Town
Private
Liner
2' Cement
3 skimmers
Diatomacious Earth
Chlorine
43
$75.00
Permit
R Qr
,s
1
IAN. 0 6 2005 U
December 31St yearly
Please make appropriate changes. Sign, date and enclose check payable to Town ofMansfield. Mail to:
Board of Health, Town of Mansfield, Six Park Row, Mansfield, MA 02048,
RAHealthTafs DocumentsTERWr APPLICATIONSISMIMMING POOLS APPAce
NAME OF CITY OR TOWN
STATE SANITARY CODE: CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS,
105 CMR 435.000
SWIMMING POOL INSPECTION REPORT
TYPF. C)F pnnT.r PtTRT.ir ❑ RRMI-PITRI.IC M """ SPFC'IAT. PITRP0gF. P00T. n
NAME OF POOL,
ADDRESS
() )
�( %�
OWNER"`
ADDRESS
DATE OF
INSPECTION
s
POOL CAPACITY
# OF GALS
6 t
INSPECTED BY
6,
METHOD OF WATER
TREATMENT
ff�
Ct
BATHER
LOAD
®
# OF LIFEGUARDS
WATER SO CE:
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: �1 U pm. # 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
2-110z) 6P#
.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 Q No Oz
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
Bromine 2.0-6.0 tn*; otal Chlorine If/ -
Alkalinity 50-150 m Free Chlorine 1.0,0 " m ".
Cyanuric Acid (30-100 pprn) Comb.
Water
.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. THE SPACE BELOW DESCRIBES VIOLATIONS MARKED ABOVE
X/✓
.34 Closure of the pool. POOL MUST BE CLOSED UNTIL IT MEETS THE STANDARDS OF
105 CMR 435.29 THROUGH 435.31.
t _
SIGNED SIGNED
opft., Board of HealtWealth Department