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OPFdiATOR �!c'�j,.� ���,j PF�tMIT P()STID #
Regulations of the Massachusette Sanitary Code: Article VI, Minimim Standards for Pools; and Town Amendments to Article VI.
1. All items approved on the construction plan are of peYmanent nature and need not be checked at each inspection.
2. }lE'ALTH: Shower and health signs posted wi�ich state that bathers take showers; na sick 'or infected bathers;
T� no glass or dangerous objects; azid children u�xier the age of 16 must be accanpanied by an adult sa+iarner within.
3. CFRTIFIID POOL OPERATORS: Must staf� at least t�w (2) certified operators in First Aid, Water Safety, C.P.R., and
have one available on the premises during pool operating hours.
4. SAFETY: One shepards crook ancl one ring buoy with adequate rop�e for each 2,000 sq. ft. water surface. One pool
divider for shallow end w.ith floatation buoys.
5. FIRST AID: First aid kit (see back), anergency telephone nur�bers �+osted, local police, state police, fire
departrs�ent, and several available physicians. Telephone available or other means of ca�munication (no+ pay
station).
6. RDCARD6: Written records available of daily operation of the pool, including attendance, water tests, chemicals
used, hours of operation, backwashing and other information required.
T. RDCIRQILATION - FILTRATION: Purification systen capable of maintaining quality of water, turnover every $ hours,
maximim filtration rate 2-3 gal. per min. per sq. ft. filter. Disinfection equignent finely adjustable. Fiaw -
meters and pressure gauges are required. �
8. DF�TH MA1tKINGS: Must be clearly markad on deck and wall of pool. Markings must be diaplayed for every foot down
to a depth of 5 feet, arrlid then at appropriate places of not more than 25 foot intervale around the deep portion of
the pool.
9. DIVING BQARD6: Rigidly constructed, properly anchored, braced for heavxest load, sc+und no splinters or cratka,
non slip surface. Not over 10 feet above water level and at least 13 feet unobstructed head roam.
_T10. WATER SOtjRGE: Water used in any swi�ing pool shall be fran a source approved by the Health Depart►rant.
�11. $ACTERIOLOGTCAL Cx1ALITY: Health Department shall cause water samples to be analyaed as considered necessary.
Quality shall meet the USPHS drinking water standards. Untreated water not over 2,400'I�PN Golifonn.
12. CF�IulICAL STAI�ARD6: Treated with chlorine or other effective method. Tests taken at least 4 times a day
as required by Nealth Department. Free Chlorine 1.0 - 3.0, pH ?.2 - 7.8, Branine Z.0 - 6.0,
Total Alkalirlity 50 - 150 p.p.m. ard Carrbined (1�lorine less than 2 p.p.m. are required onee a day.
9WIluMING P(7DL: Cl =�_ pH = T.A. = Cambined Cl =
SWIMuIIIVG PQD�� Cl = pH = T.A. = Gaaibined Cl =
WHIRI,P(IOL: � C1 = pH = T.A. = Gambined C1 =
WADING PQOL: Cl =� pH =� T.A. = C,ombined Cl =
13: TFSTING F�UIPtuII�Nf: Testing equignent provided, in good repair and canplete with fresh reagents.
�14. WATER CIARITY: A b inch black disc at bottem of deepest part of pool vtsable at 10 yards away.
15. WADING PqOL.'S; (�uality of the avater ahall be the same as swimning poola. Turnover 4 hours ar 1ess.
16. WHIRLPOOLS: Quality of the water shall be the saat�e as swirmoing pools and shall be equipped with a thermaneter and
a time instr�nent for t�e use of bathers.
17. kIVCI,OSURE: A 6 foot high fence in accordance with M.G.L. c.140 with self-closing and self-latching gates or doors.
Indoor pool must also be reatricted in a eimilar manner. Pool entrances ar►d eacits to be locked during
npn-operating hours.
18• CiAWRE: Oper3tor to close pool auhen water does not meet the requirements of thie code. Operator understands
their responsibilities in regarda to operating a pablic/sgni-pubiic swimning pool.
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ADDRF�SS ��/ J2(,�`� �� TII�EPHOIVE M&�IIt � ��i�'���
OPERATOR t��'/",�rJ�.r���JQr'1� PERMIT POSTE� # �Cf -�'?�''�'.l�C�7' '
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Regulations of the Massachusetts Sanitary Code: Article VI, Minimum Standards for Pools; and Tov�n Amenclments to Article VI. '
1. All ftems approved on the construction plan are of pernoanent nature and need not be checked at each inspection.
C��.: 2. F�ALTH: Shower and health signs posted which state that bathers take showers; no sick or infected bathers;
�� no glass or dangerous objects; and children under the age of 16 must be acccxnQanied .by an adult swiamer within.
� 3. C�tTIFIID POOL OPERATORS: Must staff at least two (2) certified operators in First Aid, Water Safety, C.P.R., and
have .one available on the premiaes during pool operating hours. ',
�,� �'�` '
C� 4. SAFETY: One shepards crook one ring buoy wi h adequate rop,e for each 2,000 sq. ft. water surface. One pool �i
divider for shallow end w.ith floatation buoys. I
"�� L,�r �
��. FIRST AID: First aid kit ee back), emergency telephone rnmbers �osted, local police, state police, fire
departmenC, and several avail .le physicians. Telephone av ilable or other means of cam�u�ication (no+ pay ,
station)• p1�1 �i 41 �n� Y�•'tl2- ����tR'i{�' C?�'
�. R�CORDS: Written records available daily operation of the pool, including attendance, water tests, chemicals ;
used, haurs of operation, backaashing a other infonnation required.
e�,�7. R�7CIRCUTATION - FILTItATION: Purification stem capable of maintaining quality of water, turnover every $ hours, �
maxim�m filtration rate 2-3 gal. per min. � t.�l er Disinfection equignent finely adjustable. Flow i
meters anti pressure gauges are re uired. �qi� i
P 401. i'y f�sS �-c, ��Y� �-c.�.,l�' "SG.� ,rir,�'� .�t�� -5�3�n �'G�c.�c �
�8. DEPTH MAItKIN(�S: Mu�t be C'learly marked on deck wall of pool. Markings aust be displayed for every fo �
' to a de th of 5 feet, and then at ro riate lace of not more than 25 foot intervals around the dee �
P aPP P P p portion of r
the poo1. '
� 9. DIVING BOARD6:F Rigidly constructed, pro ly an�hqr�,ec� ' raced for heavxest load, sound no splinters or cracks, I
non slip surface. Not ov�r 10 feet above��er 1�ve1 ac►d least 13 feet unobstructed head roan..
,� i
'j'�y�,�10: WATFR Sq,JRC�: Water used in any swfmning pool�shall be fran a urce approved by the Health Departrner_t.
� ��: 11. $AGT�RIOLAGTGAL �k� b .=tacsal�d as considered necessary. �
�' Quality shall meet the USPHS drinking water standards. Untreated wat not over 2,400 Mfii Goliform.
��12. CF�MICAL STAIVQARD6: Treated with chlorine or other effective method. Tests taken at least 4 times a day i
as required by Health Departcnent. Free C7ilorine 1.0 - 3.0, pFl 7.2 - 7.8, Bromine 2.0 - 6.0,
Total Alkalinity 50 - 150 p.p.m. ar�d Carbined Chlorine less than 2 p.p.m. are required once a day.
SN1IbMING POOL: Cl = .'Z�•6 pH = ?r fa T.A. _ ,8� Canbined Cl = r '�`
1 ��� ` T 4 �
SyVItrMING PQOL: C1 = pH = T.A. = Cambined Cl = i
WHIRI�FOOL: Cl = �M �p pH = �`r(� T.A. _/� Ganbined Cl = �
WADING POOL: C1 = pH =_� T.A. = Canbined C1 = '
j "' 13. TESTING �UIPb�Nf: Teeting equignent provided, in good repair and canQlete with fresh reagents.
�`" �,�C�,��j'�- ��}'
01�14. WATER CLARITY: A b inch black disc at bottam of deepest part of pool visable at l0 yards away. ,
�5:� WApING P(IOLa: Quality of the water shall be t�e sa�ne as swimning pool�. Thrnover 4 hours or less.
�_16. WHIRLPO�LS: Quality of the water shall-b�` the satne as swirtming pools and ahall be equipped aith a thermaneter and
a time instrunent for tt�e use of bathera. �
v� -- t>1C. C 1�U< D`tiC. "��L.s���'�� o�C'. �02c"� �
(�C17• IIV(:iASURE: A 6 oot hi fence in accordance with M.G.L. c.140 with self-closing and self-latching gates or doors.
'�'' . Indoor pool must also be restricted in a similar manner. Pool entrances ard exits to be locked during
1�,�� nqn-operating hours. k� �/ t LQ� f
�
, ��"C18• CiAS[JRE: Operator to clos� pool when water does not meet the reqqirements of this code. Operator understands
their responsibilities �n regarda to operating a public/semi-public swirrming pool. �
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10/96 . '
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THE (XIA114 ALTH OF MASSACIIUSEUS
TOM OF YAMCM
HEALTH DEPARDA Nf
POOL INSPECTION REPORT
NAME /- /�'2 �Un�GdlYli�7/!// DATE 02/ /�/Il0 f72Z
ADDRESS ��/ ®P�i% a� t��' JnS G� TELEPHONE M�F.R
OPERATOR Oc:z---q75% — er9!/ IT POST® #
o% *
Regulations of the Massachusetts Sanitary Code: Article VI, Minimun Standards for Pools; and Town Amendments to Article VI.
1. All items approved on the construction plan are of permanent nature and need not be checked at each inspection.
_ 2. HEALTH: Shower and health signs posted which state that bathers take showers; no sick or infected bathers;
no glass or dangerous objects; and children under the age of 16 must be accompanied by an adult swimmer within.
3. CERTIFIED POOL OPERATORS: Must staff at least two (2) certified operators in First Aid, Water Safety, C.P.R., and
have one available on the premises during pool operating hours.
_ 4. SAFETY: One shepards crook and one ring buoy with adequate rope for each 2,000 sq. ft. water surface. One pool
divider for shallow end with floatation buoys.
O K5. FIRST AID: First aid kit (see back), emergency telephone numbers posted, local police, state police, fire
department, and several available physicians. Telephone available or othcr means of connmic tion (no+ pay
station) . Te .5�eo n I 1 C11( C, -..� (•U CSZ-(. S
6. RECORDS: Written records available of daily operation of the pool, including attendance, water tests, chemicals
used, hours of operation, backwashing and other information required.
_ 7. RECIRCULATION - FILTRATION: Purification system capable of maintaining quality of water, turnover every 6 hours,
maximum filtration rate 2-3 gal. per min. per sq. ft. filter. Disinfection equipment finely adjustable. Flow
meters and pressure gauges are required.
8. DEPTH MARKINGS: Must be clearly marked on deck and wall of pool. Markings must be displayed for every foot down
to a depth of 5 feet, and then at appropriate places of not more than'25 foot intervals around the deep portion of
the pool.
_ 9. DIVING BOARDS: Rigidly constructed, properly anchored, braced for heaviest load, sound no splinters or cracks,
non slip surface. Not over 10 feet above water level and at least 13 feet unobstructed head room..
'OL -110. WATER SOURCE: Water used in any swimming pool shall be from a source approved by the Health Department.
o 1(n. BACTERIOLOGICAL QUALITY: Health Department shall cause water samples to be analyzed as considered necessary.
Quality shall meet the USPHS drinking water standards. Untreated water not over 2,400 MPN Coliform.
12. CHEMICAL STANDARDS: Treated with chlorine or other effective method. Tests taken at least 4 times a day
as required by Health Department. Free Chlorine 1.0 - 3.0, pH 7.2 - 7.8, Bromine 2.0 - 6.0,
Total Alkalinity 50 - 150 p.p.m. and Combined Chlorine less than 2 p.p.m. are required once a day.
SWIMMING POOL:
Cl =�
pH =
T.A. =
Combined Cl =
SWIMMING POOL:
Cl =
pH =
T.A. =
Combined Cl =
WHIRLPOOL:
C1 =
pH =
T.A. =
Combined Cl =
WADING POOL:
C1 =
pH =
T.A. =
Combined Cl =
13. TESTING .1?Q RAERT: Testing equipment provided, in good repair and complete with fresh reagents.
�14. WATER CLARITY: A 6 inch black disc at bottom of deepest part of pool visable at 10 yards away.
15. WADING POOLS: Quality of the water shall be the same as swimming pools. Turnover 4 hours or less.
16. WHIRLPOOLS: Quality of the water shall be the same as swimming pools and shall be equipped with a thermometer and
a time instrument for the use of bathers.
17. ENCLOSURE: A 6 foot high fence in accordance with M.G.L. c.140 with self-closing and self -latching gates or doors.
Indoor pool must also be restricted in a similar manner. Pool entrances and exits to be locked during
nqn-operating hours.
18. CLOSURE: Operator to close pool when water does not meet the requirements of this code. Operator understands
their responsibilities in regards to operating a public/semi-public swimming pool.
NOTES: "77PS -17 /l
/ 115 __ 0 I
PERSON INTERVIEWED POOL'INSPECTION
10/96
I i i •�
I 15••' F -D
.11 tiy•D i ,y. 1..
NAME DATE
ADDRESS `%//- TELEPHONE NUMBER
OPERATOR dGC'Crr-�5%OL �� PERMIT POSTED #
Regulations of the Massachusetts Sanitary Code: Article VI, Minimum Standards for Pools; and Town Amendments to Article VI.
1. All items approved on the construction plan are of permanent nature and need not be checked at each inspection.
l'S2. HEALTH: Shower and health signs posted which state that bathers take showers; no sick or infected bathers;
no glass or dangerous objects; and children under the age of 16 must be accompanied by an adult swimmer within.
3. CERTIFIED POOL OPERATORS: Must staff at least two (2) certified operators in First Aid, Water Safety, C.P.R., and
have one available on the premises during pool operating hours.
C5 K or-
4. SAFETY: One shepards crook and one ring buoy with adequate rope for each 2,000 sq. ft. water surface. One pool
divider for shallow end with floatation buoys.
OZ<
X 5. FIRST AID: First aid kit (see back), emergency telephone numbers posted, local police, state police, fire
department, and several available physicians. Telephone available or other means of communication (no+ pay
station).`
OK 6. RECORDS: Written records available of daily operation of the pool, including attendance, water tests, chemicals
used, hours of operation, backwashing and other information required.
Q 7. •`RECIRCULATION — FILTRATION: Purification system capable of maintaining quality of water, turnover every $ hours,
maximum filtration rate 2-3 gal. per mina per sq. ft. filter. Disinfection equipment finely adjustable. Flow
,leters and pressure gauges are required. e)}L(yC�
� 1-7 N`� 5 s r-11-1) 51PA 13 p!T ��j P� Avrr3
(J1� 8. DEPTH MARKINGS: Must a cl arly marked on deck and wall of pool. Markings must be displayed for every foot down
to a depth of 5 feet, and then at appropriate places of not more than 25 foot intervals around the deep portion of
the pool.
9. DIVING BOARDS: Rigidly constructed, properly anchored, braced for heaviest load, sound no splinters or cracks,
non slip surface. Not over 10 feet above water level and at least 13 feet unobstructed head roam..
TjL% "10. WATER SOURCE: Water used in any swimming pool shall be from a source approved by the Health Department.
6K 11, BACTERIOLOGICAL QUALITY: Health Department shall cause water samples to be analyzed as considered necessary.
Quality shall meet the USPHS drinking water standards. Untreated water not over 2,400 MEN Coliform.
CKtl2. CHEMICAL STANDARDS: Treated with chlorine or other effective method. Tests taken at least 4 times a day
as required by Health Department. Free Chlorine 1.0 - 3.0, pH 7.2 - 7.8, Bromine 2.0 - 6.0,
Total Alkalinity 50 - 150 p.p.m. and Combined Chlorine less than 2 p.p.m. are required once a day.
SWIMvIING POOL: Cl pH = �% T.A. = 14)Q Combined Cl =
SWIMAING POOL: Cl = pH = T.A. = Combined Cl
WHIRLPOOL: Cl = 1 • Ca pH = "7.(yr T.A. =9Q Combined Cl = �_
WADING POOL: Cl = pH = T.A. = Combined Cl =
613. TESTING MUIRMIr: Testing equipment provided, in good repair and complete with fresh reagents.
k - •2.0Q4P Tis -T k , i- 4-1U emsa 'Rccx
OK14. WATER CLARITY: A 6 inch black disc at bottom ofdeepest part of pool visable aY 10 yards away.
6K 15. WADING POOLS: Quality of the water shall be the same as swimming pools. Turnover 4 hours or less.
Vt 16. WHIRLPOOLS: Quality of the water shall be the same as swimming pools and shall be equipped with a thermometer and
a time instrument for the use of bathers.
0<17. ENCLASUR$: A 6 foot high fence in accordance with M.G.L. c.140 with self-closing and self -latching gates or doors.
Indoor pool must also be restricted in a similar manner. Pool entrances and exits to be locked during
non-operating hours. W__1 ) L-A.X_K.
4--18. CLOSURE: Operator to close pool when water does not meet the requirements of this code. Operator understands
their responsibilities in regards to operating a public/semi-public swimming pool.
NOTES:
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