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HomeMy WebLinkAboutTwin Oaks Apts. 12/31/2018r i Commonwealth of Ma __v Town of M--ansfield Town of Mansf z ,�jd 6 Park Rovq,y Mansfield, FAA 02048 Board of Heat�''ty1 Permit to Operate a Swiszming P PERMIT NUMBER: 3 ,i PERMIT EXPIRES: Decernber 31, 2018 Person Certified: ROB MERCIER Pool/SPA Certification Date: June 09, 2017 Pool/SPA Certification Expires: June 09, 2022 Person Certified. Pool/SPA Certification Date: Pool/Spa Certification Expires: In accordance with the provisions of Chapter 111. Section 127A of the Massachusetts General Law, and Regulations established by the Massachusetts Department of Public Health (105 CMR 435.00), permit is hereby issued to: POORVU CONSTRUCTION, CO., INC. - AGENT FOR TWIM OAKS ASSOCIATES. LLC for the operation of a ; 1 Public n Semi -Public [__] Special Purpose Pool located at: 149 OAKLAND STREET Method of water treatment is CHLORINE Bathing load not to exceed: bathers Number of Lifeguards required at all times the pool is open is: None "NO LIFEGUARD ON DUTY" sign is required. Amy Donovan-PaCmer, Heaah Agent Date Issued .gi r � Town ; f Mansfield Town of Mansfield -Board of e(0lth 6 IaRoW Mans ield, MA 02048 Swimming Pool Application PERMIT NUMBER 3 FEE: $125 l Public NAME OF OWNER: POORVU CONSTRUCTION, CO., INC. - POOL OPERATION: [j Semi -Public AGENT FOR TWIM OAKS ASSOCIATES, LLC f-' Special Purpose Pool ADDRESS: 154 WELLS AVENUE CITY: NEWTON STATE: MA ZIP: 02459 TELEPHONE: (617) 527-6945 FAX: (617) 964-3040 EMAIL: INFO@POORV U. COM FED ID/SS NO: 04-3478583 Certification Expires Every 5 Years. Permit Expires December 31st Yearly. PERSON CERTIFIED: ROB MERCIER Pool/SPA Certification Date: Pool/SPA Certification Expires: PERSON CERTIFIED: Pool/SPA Certification Date: Pool/SPA Certification Expires: certification remarks(if necessary): POOL LOCATION: 149 OAKLAND STREET TYPE/POOL: IN -GROUND POOL LENGTH: 46' VOLUME: 4000 WIDTH: 22' 21, MINIMAX DEPTH: 6 FT (MAX 3 FT (M SWIM AREA: 22'X22' WATER SOURCE: TOWN W/W DISPOSAL: TYPE OF FINISH: WHITE PLASTER SCUM GUTTER: 6/9/2017 DECK TYPE: CONCRETE 6/9/2022 SKMMR WEIR LENGTH: 16" REMARKS: i "NO LIFEGUARD ON DUTY" sign is required. No lifeguard on duty. Sign is required. DIVE AREA: 24'X22' TREATMENT SYSTEM: GROUND FILTER DISINFECT METHOD: CHLORINE CHEMICAL TREATMENT: CHLORINE NUMBER OF BATHERS: SIGNATUR DATE: 10 Please makeqapiatechanges. Sign, date and enclose check payable to Town of Mansfield. Mail to: Board of Health, Town of Mansfield, Six Park Row, Mansfield, MA 02048. TAX CERTIFICATION FORM 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. � Qaoa 0 O Individual or Corporate Name By: Corporate Officer (Mandatory, if Applicable) **Social Security No. (Voluntary) or Federal Identification Number *This license will not be issued unless this 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 Massachusetts General Law Chapter 62C, section 49A. The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 r, www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organzation Name: c (`'G 'n v Address: l�5 } W� �� I� p � t City/State/Zip: t�+G>u3 (z 1 i wA (} 02 U • ? tbone #: Are you an employer? Check the appropriate box: Business Type (required): 5. ❑ Retail 1. t"I I am a employer with _ employees (full and/ or part-time).* 6. ❑Restaurant/Bar/EatingEstablishment 2: ❑ 1 am a sole proprietor or partnership and have no 7, ❑ Office and/or Sales (incl. real estate, auto, etc.) employees working for me in any capacity. 8• ❑ Non-profit [No workers' comp, insurance required] 3. ❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, § 1(4), and we have 10.❑ Manufacturing no employees. [No workers' comp. insurance required]* 1 11.❑ Health Care 4. ❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp, insurance req.] I 12, ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. **If the corporate ofgcmn have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should cbeck box 91. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy information. Insurance Company (Name:_ o Co Insurer's Address; y,p� qq A, � � C �_ 4-v.r%) t"' � IT' ✓ / �,'�o�-i ii '' —+ 1 Policy # or Self ins. Lic. #�f � LZV "�� �- �� � i.D `-i'9 �' - �1 Expvation Date: Attach a;copy of the workers' compensation policy declaration page .(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigationofthe DIA for insurance coverage verification. I do her rtify, under thepains and penalties of perjury that the information provided above is true and correct 0'52-1 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Licensing Board 5. Selectmen's Office 6. Other Contact Person: Phone#: www.mms.gov/dia TIC- E PLOYSES NOTICT, VIA TO . . . . . . . PLO The Curmunionwealth oto Nilassdachusetts I CorjArvv� Sorrel, SURV 141,11, himuchuVW 02114 201' IQ, I how v il� ux?X I e,yct em V I Ox MA K v NUMMY still kuklyls, PKISM A& (Wt too" my; AN Ap— W't YOM, t4a 1%"Xql W, fW'Im As, two , F 40 D ARM ....... . . ...... s &I01 aJ w� I to r", �,q ol h,-f l �he V�A,ju, DAN p-A it ipum!r WVVly MJIVIIOJ " tpo its jjj,tt I man su 401 OWN4, Efit. n4w F.om:Nnllonol 8wlminln0 Pool Fntln 7108462787 ' 11/07/2017 14:48 0880 P.0011001 O rr� V t C� O Q� 76 O L _W V NSPF® authorized fax copy For verification, call 710.640.9119 or email servlce@nspf.org Sao;dsu�oouvas ilewo 10 6668'Qf SUL Ileo'uogeolljen god Rdoo xe; pazNoyine ®ddSN� Jane Doucette From: Jane Doucette Sent: Tuesday, June 06, 2017 1:37 PM To: 'Dianna Bordenca' Subject: RE: Twin Oaks Pool Permit Thanks From: Dianna Bordenca [mailto:dianna(cbpoorvu.com] Sent: Tuesday, June 06, 2017 12:49 PM To: Jane Doucette Subject: RE: Twin Oaks Pool Permit Hi Jane, Please see attached certificate of WC insurance Thanks! Best regards, Dianna Bordenca Resident Manager Poorvu-Construction 154 Wells Ave Newton, MA 02459 617-527-6945 617-964-3040(Fax)' Dianna@rnoorvucom �=w vmau From: Jane Doucette[mailto:JdoucetteCcbmansfieldma.com] Sent: Tuesday, June 06, 2017 12:05 PM To: 'INFO@POORVU.COM' Subject: Twin Oaks Pool Permit Just to let you know we will need the workers'comp insurance certificate from your insurance carrier before we can process the swimming pool permit. Thanks. Disclaimer The information contained in this communication from the Town of Mansfield is confidential. It is intended solely for use by the recipient and others authorized to receive it. If you are not the recipient, you are hereby notified that any disclosure, copying, distribution or taking action in relation of the contents of this information is strictly prohibited and may be unlawful. ISDUALSWG Rev G �� HAYWARD DUAL SUBMERGED SUCTION OUTLET SET [Commonly called main drains] For Models: WG1030, WG1048, WG1049, WG1051, WG1052, WG 1053, WG1054, WG1153, WG1154 Covers: WG1048E, WG1048EDGR, WG1048EGR, WG1048EBLK IMPORTANT SAFETY INSTRUCTIONS Basic safety precautions should always be followed, including the following: Failure to follow instructions can cause severe injury and/or death. AThis is the safety -alert symbol. When you see this symbol on your equipment or in this manual, look for one of the following signal words and be alert to the potential for personal injury. AWARNING warns about hazards that could cause serious personal injury, death or major property damage and if ignored presents a potential hazard. ACAUTION warns about hazards that will or can cause minor or moderate personal injury and/or property damage and if ignored presents a potential hazard. It can also make consumers aware oil actions that are unpredictable and unsafe. The NOTICE label indicates special instructions that are important but not related to hazards. Hayward Pool Products 62o Division Street, Elizabeth, NJ 07207 Phone: (9o8) 351.5400 www.hayward.com HAYWARIY A WARNING - Read, understand and follow all instructions in this owner's manual and on the equipment. Failure to follow instructions can cause severe injury and/ordeath. A WARNING — Suction Entrapment Hazard. Suction in suction outlets and/or suction outlet covers which are, damaged, broken, cracked, missing, or unsecured can cause severe injury and/or death due to the following entrapment hazards: Hair Entrapment- Hair can become entangled in suction outlet cover. Limb Entrapment -A limb inserted into an opening ofa suction outlet sump or suction outlet cover that is damaged, broken, cracked, missing, or not securely attached can result in a mechanical bind or swelling of the limb. Body Suction Entrapment -A negative pressure applied to a large portion of the body or limbs can result in an entrapment. Evisceration/ Disembowelment -A negative pressure applied directly to the intestines through an unprotected suction outlet sump or suction outlet coverwhich is, damaged, broken, cracked, missing, or unsecured can result in evisceration/ disembowelment. Mechanical Entrapment -There is potential forjewelry, swimsuit, hair decorations, finger, toe or knuckle to be caught in an r opening of a suction outlet cover resulting in mechanical entrapment. A WARNING - To Reduce the risk of Entrapment Hazards: o When outlets are small enough to be blocked by a person, a minimum of two functioning suction outlets per pump must be installed. Suction outlets in the same plane (i.e. floororwall), must be installed a minimum of three feet (3') [i meter) apart, as measured from near point to near point. o Dual suction fittings shall be placed in such locations and distances to avoid "dual blockage" by a user. o Dual suction fittings shall not be located on seating areas or on the backrest for such seating areas. o The maximum system flow rate shall not exceed the flow rating of as listed on Table i. o Never use Pool or Spa if any suction outlet component is damaged, broken, cracked, missing, or not securely attached. o Replace damaged, broken, cracked, missing, or not securely attached suction outlet components immediately. o In addition two or more suction outlets per pump installed in accordance with latest ASME, APSP Standards and CPSC guidelines, follow all National, State, and Local codes applicable. a Installation of vacuum release orvent system, which relieves entrapping suction, is recommended. A WARNING — Failure to remove pressure test plugs and/or plugs used In winterization of the pool/spa from the suction outlets can result in an increase potential for suction entrapment as described above. A WARNING — Failure to keep suction outlet components clear of debris, such as leaves, dirt, hair, paper and other material can result in an increase potential for suction entrapment as described above. A WARNING — Suction outlet components have a finite life, the cover/grate should be inspected frequently and replaced at least every seven years or if found to be damaged, broken, cracked, missing, or not securely attached. A CAUTION — Components such as the filtration system, pumps and heater must be positioned so as to prevent their being used as means of access to the pool by young children. To reduce risk of injury, do not permit children to use or climb on this product. Closely supervise children at all times. Components such as the filtration system, pumps, and heaters must be positioned to prevent children from usingthem as a means of access to the pool. AWARM NG — Hazardous Pressure. Pool and spa water circulation systems operate underhazardous pressure during start up, normal operation, and after pump shut off. Stand clear of circulation system equipment during pump start up. Failure to follow safety and operation instructions could result in violent separation of the pump housing and cover, and/or filter housing and clamp due to pressure in the system, which could cause property damage, severe personal injury, or death. Before servicing pool and spa water circulation system, all system and pump controls must be in off position and filter manual air relief valve must be in open position. Before starting system pump, all system valves must be set in a position to allow system waterto return back to the pool. Do not change filter control valve position while system pump is running. Before starting system pump, fully open filter manual air reliefvalve. Do not close filtermanual airrellef valve until a steadystrearn of water (not air oralrand water) is discharged. y� AWARNING —Sep a ration Hazard. Failure to follow safety and operation instructions could result in violent separation of pump and/or fitter components. Strainer cover must be properly secured to pump housing with strainer cover lock ring. Before servicing pool and spa circulation system, filters manual air relief valve must be in open position. Do not operate pool and spa circulation system if a system component is not assembled property, damaged, or missing. Do not operate pool and spa circulation system unless filter manual air relief valve body is in locked position in filter upper body. Never operate or test the circulation system at more than 50 PSI. Do not purge the system with compressed air. Purging the system with compressed air can cause components to explode, with risk of severe injury or death to anyone nearby. Use only a low pressure (below 5 PSI), high volume blowerwhen air purging the pump, filter, or piping. 2 HAYWARD° A WARNING —Risk of Electric Shock. All electrical wiring MUST be in conformance with applicable local codes, yi regulations, and the National Electric Code (NEC). Hazardous voltage can shock, burn, and cause death or serious property damage. To reduce the risk of electric shock, do NOT use an extension cord to connect unit to electric supply. Provide a properly located electrical receptacle. Before working on any electrical equipment, turnoff power supply to the equipment. Toreduce the risk of electric shock replace damaged wiring immediately. Locate conduit to prevent abuse from lawn mowers, hedge trimmers and other equipment. Do NOT ground to a gas supply line. AWARN I NG —Risk of Electric Shock Failure to ground all electrical equipment can cause serious or fatal electrical shock hazard. Electrical ground all electrical equipment before connecting to electrical power supply. A WARN I NG —Risk of Electric Shock Failure to bond all electrical equipment to pool structure will increase risk for electrocution and could result in injury or death. To reduce the risk of electric shock, see installation instructions and consult a professional electrician on how to bond all electrical equipment. Also, contact a licensed electrician for information on local electrical codes for bonding requirements. Notes to electrician: Use a solid copper conductor, size 8 or larger. Run a continuous wire from external bonding lug to reinforcing rod or mesh. Connect a No. 8 AWG (8.4 mm°) [No. 6 AWG (13.3 mw) for Canada] solid copper bonding wire to the pressure wire connector provided on the electrical equipment and to all metal parts of swimming pool, spa, or hot tub, and metal piping (except gas piping), and conduit within 5 ft. (1.5 m) of inside walls of swimming pool, spa, or hot tub. IMPORTANT- Reference NEC codes for all wiring standards including, but not limited to, grounding, bonding and other general wiring procedures. AWARNING — Risk of Electric Shock. The electrical equipment must be connected only to a supply circuit that is protected by ground -fault circuit -interrupter (GFCI). Such a GFCI should be provided by the installer and should be tested on a routine basis. To test the GFCI, push the test button. The GFCI should interrupt power. Push reset button. Power should be restored. If the GFCI fails to operate in this manner, the GFCI is defective. If the GFCI interrupts powerto the electrical equipment without the test button being pushed, a ground current is flowing, indicating the possibility of an electrical shock. Do not use this electrical equipment. Disconnect the electrical equipment and have the problem corrected by qualified service representative before using. ACAUTION — HAYWARD® pumps are intended for use with permanently -installed pools and may be used with hot tubs and spas if so marked. Do not use with storable pools. A permanently -installed pool is constructed in or on the ground or in a building such that it cannot be readily disassembled for storage. A storable pool is constructed so that it is capable of being readily disassembled for storage and reassembled to its original integrity. AWARN I NG — Risk of Hyperthermla. To avoid hyperthermia the following "Safety Rules for Hot Tubs" are recommended by the U.S. Consumer Product Safety Commission. 1. Spa or hot tub water temperatures should never exceed ioq°F[µo°C]. A temperature of 1000F[380C]is considered safe fora healthy adult. Special caution is suggested foryoung children. Prolonged immersion in hot water can induce hyperthermia. 2. Drinking of alcoholic beverages before or during spa or hot tub use can cause drowsiness, which could lead to unconsciousness and subsequently result in drowning. 3. Pregnant women beware! Soaking in water above ioo°F [38°C] can cause fetal damage during the firstthree months of pregnancy (resulting in the birth of a brain -damaged or deformed child). Pregnantwomen should adhere to the ioo°F [38°C] maximum rule. q. Before enteringthe spa orhottub, users should checkthe water temperature with an accurate ther- mometer; spa or hot tub thermostats may err in regulating water temperatures by as much as 40F (2.20C). 5. Persons taking medications, which induce drowsiness, such as tranquilizers, antihistamines or anti- coagulants, should not use spas or hot tubs. 6. If the pool/spa is used fortherapy, it should be done with the advice of a physician. Always stir pool/ spa water before entering the pool/spa to mix in any hot surface layer of water that might exceed healthful temperature limits and cause injury. Do not tamperwith controls, because scalding can result if safety controls are not in properworking order. 7. Persons with a medical history of heart disease, circulatory problems, diabetes or blood pressure problems should obtain a physicians advice before using spas or hot tubs. 8. Hyperthermla occurs when the internal temperature ofthe body reaches a level several degrees above normal body temperature of98.6°F [370C]. The symptoms of Hyperthermia include: drowsiness, lethargy, dizziness, fainting, and an increase in the internal temperature of the body. The effects of Hyperthermla include: 1. Unawareness of impending danger. 2. Failure to perceive heat. 3. Failure to recognize the need to leave the spa. q. Physical inability to exit the spa. 5. Fetal damage in pregnant women. 6. Unconsciousness resulting in danger of drowning. SAVE THESE INSTRUCTIONS HAYWARIY RECOMMENDED SYSTEM SPECIFICATIONS: ACCEPTABLE PIPE SIZE FOR MAXIMUM RECOMMENDED SYSTEM FLOW RATE PER APSP-7 (6 FT/SEC IN THE BRANCH LINE) Pipe Size Flow rate Pipe Size Flow rate [mm] GPM [mm] GPM [Liter/Min] [Liter/Min] 11/2>, 40 21/2 go 1501 11501 1751 13401 2" 63 [631 [2401 1901 15221 CHART Flow vs Pressure Drop FIG 1 Note: 1"Hg=1.13 Ft of Head WG1048E, WG1o48EGR, WG1o48EDGR and WG1048EBLK Suction outlet Covers are rated for the Floor at 125 GPM and the Wall at 72 GPM. In the event of one suction outlet being blocked, the remaining suction outlets serving that system shall have a flow rating capable of the full flow of the pumps) forth specific suction system. Example: In the System shown in Diagram 1, two (2) suction outlet covers are selected and mounted on the Floor. These covers are individually rated for 125 GPM. For a desired flow rate through the pump of too GPM, a minimum pipe size from the Chart i is selected at 3". At the desired flow of too GPM one cover could be partially blocked and the other suction outlet flow would be below the rated 125 GPM of the "Floor" mounted suction outlet cover. Since there are two outlets flowing in normal operation, and the allowable velocity in the interconnecting piping is only aft/sec, the same pipe size is required in the interconnecting piping. Example: In the System shown in Diagram 2, one (1) suction outlet cover mounted in the floor, rated at 125 GPM, and one (i) suction outlet cover mounted on the wall, rated at 72 GPM. For a desired flow rate through the pump of 5o GPM, a minimum pipe size from the Chart 1 is selected at 2". At the desired flow of 5o GPM either cover could be totally blocked and the other suction outlet flow would be below the rated 72 GPM of the wall mounted suction outlet cover. Note: Flow may be limited by entrapping force in dual suction systems. Minimum distance 3 feet (Pipe Centerline) Floor outlets, .,rr�wr��♦ Total system rated R.. GPM Tin Flo 125 GPM Dual Outlets on Different Planes (Elevation or Plan View) system urancn Piping Diagram 2 HAYWARKY INSTALLATION INSTRUCTIONS: - Use a #2 Philips head Screwdriver. NOTICE: When installing WGi03oAVPAI(2 refer to the latest version of APSP16 forth proper instructions on how to construct the field -fabricated sump. Figure 2 is an illustration of some of the requirements. Suction outlets for a pool with a vinyl liner and for fiberglass pools are provided with a WG2048B mounting ring and two (2) gaskets. The gaskets should be placed such that they sandwich the liner or fiberglass, that is, one gasket on each side. The ring (WGs048B) is attached to the suction outlet by eight (8) screws that pass through both gaskets and the liner. See diagram below. GASKET GASKET SELF TAPPING SCREWS SEAL RING BODY POOL LINER Suction outlets for a concrete or gunite pools are designed to be plastered with the top surface flush to the pool surface. An Adjustable Collar WGio5iX may be used to aid in obtaining the desired configuration. Two screws MUST be used to secure the cover to the suction outlet. USE ONLY HAYWARD GENUINE REPLACEMENT PARTS INCLUDING THE SCREWS. F4.2 N14645ump t L21:.,itLL:LL� [..t.tll!..L[!tiLi t3ii14 ■ i D 7 tlrvi. j `pr s �ASDk Dr�i. � 3.D S , 6E!e�;d 39ti?: bi D-tile ."x=-V.t+t1 Fx. <elrotM =-z (.. ja�certg5a;�s_=JtF!'S'=;tn. COLLECTOR TUBE � r• i. taD n 3D1 i COVER BODY HYDROSTATIC RELIEF VALVE For installations utilizing a hydrostatic relief valve (SP1056), using a collectortube (SP1055) will maintain a clear path to the hydrostatic valve. At least one hydrostatic relief valve in a set of suction outlets will allow hydrostatic uplift pressure caused by ground waterto be relieved into the pool or spa. LO HAYWARD° SPARE PARTS LISTS BODY POOL LII+iF'A WG1048AVPAI<2 / WG1049AVPAI(2 WG1048AVDGRPAI<2 / WG1049AVDGRPAI(2 WG1048AVGRPAK2 / WG1049AVGRPAI(2 WG1048AVBLKPAK2 / WG104gAVBLI<PAK2 WG105iAVPAK2/ WG1052AVPAI<2 WG1053AVPAK2/ WG1054AVPAI(2 ITEM SPARE PART DESCRIPTION CITY 1 WGX103OZ2A PLASTIC TAP SCREW SET i.o 1 WGX1030Z2AM METAL INSERT SCREW SET i.a *WGX1048E WHITECOVER *WGX1048EDGR DARK GRAY COVER 2 *WGX1048EGR GRAYCOVER 1.0 *WGX1048EBLK BLACK COVER WGX1048B WHITE RING WGX1048BDGR DARK GRAY RING 3 WGX1048BGR GRAY RING 1.0 WGX1048BBLK BLACK RING 4 SPX1048D GASKET 2.0 i 1/z IN PLASTIC PIPE 5 SPX1o51Z1 1.0 PLUG 2 IN PLASTIC PIPE 6 SPX1053Z1 1.0 PLUG 7 SPX1o39Zi8 SCREW SET 1.0 NOTES: All color variations of WG1048AVPAK2 / WG1049AVPAK2 have 11/1" NPT Plug for the bottom port. *-SPARE COVER INCLUDES SCREWS FOR ALL VARIATIONS OF SUMPS, WITH OR WITHOUT METAL INSERTS. ITEM SPARE PART DESCRIPTION QTY 1 WGX1030Z2A PLASTICTAP SCREW SET i.o 1 WGX1030Z2AM METAL INSERTSCREW SET 1.o *WGXa048E WHITE COVER *WGX1048EDGR DARK GRAY COVER z *WGX1048EGR GRAY COVER 1.0 *WGX1048EBLK BLACK COVER 1 1/2 IN PLASTIC PIPE 3 SPX1051Z1 10 PLUG 2IN PLASTIC PIPE 4 SPX1053Z1 1.0 PLUG NOTES: WGio51AVPAK2 / WG1052AVPAK2 have 11/1" NPT Plug WG1053AVPAK2 / WG1054AVPAK2 have 2" NPT Plug *-SPARE COVER INCLUDES SCREWS FOR ALL VARIATIONS OF SUMPS, WITH OR WITHOUT METAL INSERTS. A WGu53AVPAK2 / WG1154AVPAK2 WG1154SPAK2 / WG1154SBLKPAI<2 WG1154SDGRPAK2 / WG1154SGRPAK2 ITEM SPARE PART DESCRIPTION QTY 1 WGX103OZ2A PLASTIC TAP SCREW SET 1.0 1 WGX1030Z2AM METAL INSERT SCREW SET 1.o *WGX1048E WHITECOVER *WGX1048EDGR DARK GRAY COVER 2 *WGX1048EGR GRAY COVER 1.0 *WGX1048EBLK BLACK COVER WGX1153B WHITE COLLAR WGX1153BDGR DARK GRAY COLLAR 3 WGX1153BGR GRAY COLLAR 1.0 WGX1153BBLK BLACK COLLAR 11/2 IN PLASTIC PIPE y SPX1o51Z1 i.o PLUG 2IN PLASTIC PIPE 5 SPX1053Z1 1.0 PLUG NOTES: WGu53AVPAK2 / WG1154AVPAK2 have 2" NET Plug WG1154SxxPAK2 has 2" NPT Plug *-SPARE COVER INCLUDES SCREWS FOR ALL VARIATIONS OF SUMPS, WITH OR WITHOUT METAL INSERTS. SEE NOTICE ON PAGE 5 FOR FIELD FABRICATED OUTLETS WG103oAVPAK2 / WG103oAVDGRPAI<2 WG103oAVGRPAI<2 / WG103oAVBL1<PAI<2 ITEM SPARE PART DESCRIPTION QTY 1 WGX1030Z2A PLASTIC TAP SCREW SET 1.0 1 WGX103OZ2AM METAL INSERT SCREW SET 1.0 *WGX1048E WHITE COVER *WGX1048EDGR DARK GRAY COVER 2 *WGX1048EGR GRAY COVER 1.0 *WGX1048EBLK BLACK COVER WGX1058C WHITE ROUND FRAME WGX1058CDGR DARK GRAY FRAME 3 WGXio58CGR GRAY FRAME 1.0 WGX1o58CBLK BLACK FRAME NOTES: *-SPARE COVER INCLUDES SCREWS FOR ALL VARIATIONS OF SUMPS, WITH OR WITHOUT METAL INSERTS. SAVE THESE INSTRUCTIONS FOR FUTURE REFERENCE. HAYWARD@ LIMITED WARRANTY To Buyer, as original purchaser of this equipment, Hayward Pool Products, 62o Division Street, Elizabeth, New Jersey, warrants its products free from defects in materials and workmanship for a period of ONE (i) year from the date of purchase. Parts which fail or become defective during the warranty period, except as a result of freezing, negligence, improper installation, use, or care, shall be repaired or replaced, at our option, without charge, within go days ofthe receipt of defective product, barring unforeseen delays. To obtain warranty replacements or repair, defective components or parts should be returned, transportation paid, to the place of purchase, orto the nearest authorized Hayward service center. For further Hayward dealer or service center information, contact Hayward customer service department. No returns may be made directly to the factory without the express written authorization of Hayward Pool Products. To original purchasers of this equipment, Hayward Pool Products warrants its products to be free from defects in materials and workmanship for a period of ONE (a) year from the date of purchase. Filters which become defective during the warranty period, except as a result of freezing, negligence, improper installation, use or care, shall be repaired or replaced, at our option, without charge. All other conditions and terms of the standard warranty apply. Hayward shall not be responsible for cartage, removal and/or reinstallation labor or any other such costs incurred in obtaining warranty replacements. The Hayward Pool Products warranty does not apply to components manufactured by others. For such products, the warranty established by the respective manufacturer will apply. Some states do not allow a limitation on how long an implied warranty lasts, or the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion may not apply to you. This warranty gives you specific legal rights, and you may also have other rights, which vary from state to state. Hayward Pool Products 620 Division Street *Supersedes all previous publications. Elizabeth, NJ 07207 PRODUCT REGISTRATION DATE OF INSTALLATION (Retain For Your Records) ♦Retain this Warranty Certificate (upper portion) in a safe and convenient location for your records. DETACH HERE: Fill out bottom portion completely and mail within io days of purchase/Installation or register online. CT� ----------------------------------------------- DUAL SUCTION OUTLET SET Register online at www.hayward.com Please Print Clearly: First Name_ Street Addres: City Phone Numbe E-Mail Addres Model Number Last Nam State Zi Purchase Date Pool Capacity (U.S. Gallons) OPlease include me on all e-mail communications regarding Hayward® Equipment or promotions. Mail to: Hayward Pool Products, 62o Division Street, Elizabeth, NJ 07207 Attn: Warranty Dept Or REGISTER YOUR WARRANTY ON-LINE AT WWW.HAYWARD.COM Y Hayward is a registered trademark of n Hayward Industries, Inc. © 2013 Hayward Industries, Inc. Town of Mansfield y 9NEGlNC 6 Park Row, Mansfield, Massachusetts 02048 508-261-7366 Health Department Amy Donovan -Palmer, Health Agent STATE SANITARY CODE: CHAPTER V, MINIMUM STANDARDS FOR SWIMMING POOLS, 105 CMR 435.000 SWIMMING POOL INSPECTION REPORT TYPE OF POOL: PUBLIC ❑ SEMI-PUBLIC & PECIAL PURPOSE POOL ❑ NAME OF POOL Tw �v` O ass ADDRESS 1ye� Oc��c-�a..•-.d Sy- OWNER ADDRESS \Skk_L0 'eve DATE OF INSPECTION I 1 a �O POOL CAPACITY # OF GALS a,, coo INSPECTED BY A c� v7 �"C� METHOD OF WATER TREATMENT Cam"' BATHER LOAD # OF LIFEGUARDS WATER SOURCE: A-pu„r 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 1\ .03 Adequate enclosure around pool. Gate self -latching w/ latch 4 it above ground. .04 Sewage Disposal .05 Location, structural stability, finish. .06 Water circulatioq& nitration systems. Filter Effluent flow meter reading: 1gpm. #ofturnovers(,.t- 6 .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 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 purpo a pools. .23 Lifeguards required: Yes No ❑ If lifeguards required. Prope 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 h cyk� r.c\ s n' wdiV�rrc1 C� POOLSIDE READINGS Bromine 2.0-6.0 m* Total Chlorine Alkalinity 50-150 m Free Chlorine 1.0-3.0 m O Cyanuric Acid (30.100 ppm) Comb. Chlorine (0.0-0.2 ppm) 0.0 Water Temp. 104°F. pH level (7.2-7.8) , �{ * 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 h) A Mec�Svc2 cow--W�v�2c7 Cl