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THE (XJ MI1NFALTH OF MASSAQ USETrS
TOWN OF YARNOU H
HEALTH DEPARI11tNr
POOL INSPECTION REPORT
N /4erl 17=nC"/"Gf7 7^/-A.J * -`7:',,....' I '.S DATE - / 7/. S
ADDRESS 13 / 1"t Pticl11e ` S� TELEPHONE NUMBER
OPERATOR t-', y L.ST'F C., L3 /4//7/2---3, 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.
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2. HEALTH: Shower and health signs posted which state that bathers take showers; no sick or infected bathers;
no glass or dangerous objects1Thand i-ldi-en under the age of ,16 nust be ac ° anied by an dult swimmer within.
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4C4 -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<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.
014. FIRST AID: First aid kit (see back), emergency telephone numbers posted, local police, state police, fire
department, and several available physicians. T lephone available or other means of communication (not pay
station). 1 // 2- 'Lc' c f / Gl›z/1
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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.
C 7. REXIRCULATION - FILTRATION: Purification system capable of maintaining quality of water, turnover every 8 hours,
� �rivun filtration rate 2-3 gal. per min r2 s ft. filter. Disinfection equipment finely adjustable. Flow
rum
and press4�gauQes are„irequired. �4� 4� ,� ,/ e f,.y
,, CMG L ca � y,Z, 01
8. IEPTH MARKINGS: Must be clearly mar-Red 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.
A*4. 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.
16r10. WATER SOURCE: Water used in any swimming pool shall be from a source approved by the Health Department.
0(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 MPN Coliform.
(.X12. 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 = oP/0 pH = 7 i T.A. = 96) Combined Cl =
SWIMMING. POOL: Cl = pH = T.A. = Combined Cl =
WHIRLPOOL: Cl = 2, 0 pH = 'Z 5 T.A. _ 961) Combined Cl = CD
, WADING POOL: Cl = pH = T.A. = Combined,C1 =
,l4 1 O3. TESTING E1QUIPMENT: Testing equipment provided,_in go a it and complete with fresh reagents. '
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`G4. WATER CLARITY: A 6 inch black disc at bottom of deepest part of pool visable at 10 yards away.
5. 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 therm m eter and
a tip/iDstr nt for th use of bathers. / -{
� s oil 6r�f /GY / :" CPS e , ��-ram S�- '` G C7l i
CJ 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 a1,so be �restricf�d in a similar manner. Pool entrances and exits to be locked during
non-operating hours. /S-9 / L.Cr e
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u18. 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.
11 �
NOTES: A/Q 9/ l C��'JC'D
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10/96 1 `
AFEtY SItNC3 AND IVI IPM NI'
1. Signs to be posted at the pool include:
* All persons are required to take a cleansing shower before entering the pool.
* No person with a communicable disease is allowed to use the noel.
* No bather shall wear a bathing suit that is unclean.
• No person suffering from a cough, cold, inflammation of the eves, nasal or ear nischarge.s, or a-,y otlicr
communicable disease shall be allowed to use the pool.
* No person with sores or other evidence of skin disease, or who is wearing a bandage or medical vover;ng of any
kind, shall be allowed use of the pool.
* No person shall spit or in any other way contaminate the paoi, or its floors, walkways, aisles, c.- dressing
roams.
* No glass containers shall be permitted in the pool or on walkways within 8 feet of the pool.
* No person shall bring or throw into the pool any object that may in any way carry contamination or envassger the
safety of the bathers.
2. Lifeguards and operators crust enforce the rules noted on the above-signs.
3. A shephards crook or reaching pole with a minimum handle length that extends greater than 18 feet „ast be provrdee: ter
each 2,000 sq. ft. of water surface area (MGL, c140, s206).
4. One Ring Buoy or Rescue Tube with a i" polyethelene rope attached, no less in length than 14 the width of the pool
If the pool has lifeguards, a rescue tube crust be located at each station.
5. Emergency communication equipment mast be available for reaching emergency response persons. Appropriate teleplicne
numbers and directions for the use of the equipment nest be posted.
6. There crust be an appropriately equipped first aid kit. Public pools must have a roan designed and equipped for
emergency care of sick and injured bathers.
7. Whirlpool - Must be drained every 30 days and scrubbed and disinfected.
FIRST AID KIT
35 1" Band-Aids
10 3" x 3" sterile gauze pads
2 5" x 5" Burg:pads
8' x 10" surgipad
1 2" soft roller bandage
2 3" sort roller bandages
1 roll 1/2' hypoallergenic tape
triangular bandage
I scissors
rescue blanket
12 antiseptic wipes
Z, disposable instant ice packs
sterile isotonic buffered eye wash
2 pair one size-fits-all latex gloves
1 rnicroshield or pocket mask with a one way valve
POOL LOGS
logs crust be kept each day the pool is in operation.
Test for: Free Chlorine 4X/day
Combined Chlorine 1X/day
pH 4Xl day
Total Alkalinity 1X/day
Also note on the log: Clarity Good/Average/Poor
Chlorinator On/Off
Chlorinator Setting Low/MediuniHigh or 1/2/3, etc.
Weather Sunny/Cloudy, etc.
Air Temperature
Bather Load
Chemicals Added
Any Other Actions Taken
Initials of Tester
ADMINISTRATION
I'(X)L CLOSURE
1T IS THE RESPONSIBILITY Of THE P(X)L OPERATOR TO CLOSE THE POOL WHEN ANY OF THE CHEMICAL, PHYSICAL OR SAEEIY summit; ARE
NOT MET, OR FOR ANY OTHER REASON MAT WOULD MAKE POOL. USE UNSAFE. USE GOOD JU G MENT!!! ERR ON THE SIDE OF SAFE:lY
in compliance with MGL 140.206, when closing your outdoor inground swimming pool for the season, pools (rust be drained s;:d
remain dry throughout closure time, or covered within seven (7) days of closing.
PIV,L OPENING
In the event that your pools have been closed for the season, all swimming, wading and whirlpools are to be inspected by the
Health Department prior to opening.
Prior to calling for an inspection appointment, a water sample from each pool and whirlpool roast he submitted for testis
for conform and pseudoiainas by an independent lab. i,ab results resist be submitted prior to inspection and :;per:eng.
Food Establishment Inspection Report - Town of Yarmouth Yarmouth tB�s s IHeaam,outn,MA 02664
Establishment: ,49- -).7c ,S rir'e:5i --/t'7 (4 `jvr -'`, Date: '?r/ 7/ 2' Page 1 of 34-
Address: ;-3/hi R� a g) 'Jv" Time in: ` Time out: JI
Telephone: Permit No.: Number of Violated Provisions Related
to Foodborne Illness Risk Factors
Owner: and Interventions(Items 1 through 29):
Person-in-charge: Number of Repeat Violations Related
��// to Foodborne Illness Risk Factors
Inspector: �P C tJ CA, and Interventions(Items 1 through 29):
Type of Operation(s): lee of Inspection: Other Information:
❑ Food Service Establishment outine
❑ Retail Food Store 0 Re-inspection
❑ Residential:Cottage Foods D Pre-operational
❑ Residential;Bed& ❑ Illness investigation
Breakfast 0 General complaint
❑ Mobile/Pushcart ❑ HACCP
0 Temporaroo Estab. , 0 Other
Other
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS 5 POINTS
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection R=repeat violation
Compliance Status IN OUT N/AIN/O cost R Compliance Status IN ouTI N/A IN/O cos R
Supervision Protection from Contamination
1 Person-in-charge present, demonstrates 15 Food separated and protected t/
knowledge, and performs duties 16 Food-contact surfaces; cleaned &
2 Certified Food Protection Manager sanitizedIl I./
Employee Health Proper disposition of returned, /
Management, food employee and 17 previously served, reconditioned & [/
3 conditional employee; knowledge, v unsafe food
responsibilities and reporting Time/Temperature Control for Safety
4 Proper use of restriction and exclusion l!f 18 Proper cooking time &temperatures -
r
5 Procedures for responding to vomiting 19 Proper reheating procedures for hot
and diarrhea) events holding
Good Hygienic Practices 20 Proper cooling time and temperature
6 Proper eating, tasting, drinking, or 21 Proper hot holding temperature
tobacco use 22 Proper cold holding temperature
7 No discharge from eyes, nose, and 23 Proper date marking and disposition
mouth Preventing Contamination by Hand 24 Time as a Public Health Control �'
8 Hands clean & properly washed V Consumer Advisory
No bare hand contact with ready-to-eat / 25 Consumer advisory provided for raw/
9 food V undercooked food '
Adequate handwashing sinks properly Highly Susceptible Populations
10 supplied and accessible 26 Pasteurized foods used; prohibited foods
Approved Source - not offered
.� Food/Color Additives and Toxic Substances
11 Food obtained from approved source /
12 Food received at proper temperature I! 27 Food additives: approved & properly L
used
13 Food received in good condition, safe, & / 28 Toxic substances properly identified, Iunadulterated stored & used
Required records available: shellstock Conformance with Approved Procedures
14[tags, parasite destruction
29 Compliance with variance/ specialized G
process/ HACCP Plan
GOOD RETAIL PRACTICES AND MASSACHUSETTS-ONLY SECTIONS 2 POINTS
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection R=repeat violation
Compliance Status I IN IOUTI N/A I N/O Icost R Compliance Status IN OUT N/A N/O cos R
Safe Food and Water 48 Warewashing facilities: installed,
Pasteurized eggs used where maintained, & used; test strips
30 required 49 Non-food contact surfaces clean
31 Water& ice from approved source . E _ Physical Facilities
32 Variance obtained for specialized 50 Hot&cold water available;
processing methods ^adequate pressure
Food Temperature Control 51 Plumbing installed; proper backflow Ille
Proper cooling methods used; _devices
Sewage&waste water properly
33 adequate equipment for 52 i
temperature control disposed
34 Plant food properly cooked for hot 53 Toilet features: properly
holding constructed, supplied, &cleaned
35 Approved thawing methods used 54 Garbage& refuse properly
36 Thermometers provided & accurate disposed; facilities maintained
Food Identification 55 Physical facilities installed,
Food properly labeled; original maintained, &clean
37 II 56 Adequate ventilation & lighting;
Prevention of Food Contamination designated areas used
Insects, rodents, & animals not Additional Requirements listed in 105 CMR 590.011
38 present M1 Anti-choking procedures in food
service establishment
Contamination prevented during M2 Food allergy awareness
39 food preparation, storage and
display Review of Retail Operations listed In 105 CMR 590.010
40 Personal cleanliness M3 Caterer
Wiping cloths: properly used & M4 Mobile Food Operation
41 stored M5 Temporary Food Establishment
42 Washing fruits& vegetables s M6 Public Market; Farmers Market
Proper Use of Utensils Residential Kitchen; Bed-and-
43 In-use utensils properly stored M7 Breakfast Operation
Utensils, equipment& linens: Residential Kitchen: Cottage Food
44 properly stored, dried, & handled _ M8 Operation
Single-use/single-service articles: School Kitchen; USDA Nutrition
45 properly stored & used M9 Program
46 Gloves used properly M10 Leased Commercial Kitchen
Utensils,Equipment and Vending M11 Innovative Operation
o
Food & non-food contact surfaces I I I
47 cleanable, properly designed, L1 Local law or regulation
Requirements
constructed & used L2 )Other c
Official Order for Correction: Based on an inspection today,the items marked"OUT"indicated violations of 105 CMR 590.000 and
applicable sections of the 2013 FDA Food Code. This report,when signed below by a Board of Health member or its agent constitutes
an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food
establishment permit and cessation of food establishment operations. If you are subject to a notice of suspension, revocation,or non-
renewal pursuant to 105 CMR 590.000 you may request a hearing before the board of health in accordance with 105 CMR 590.015(B).
Date of Reinspection: Discussion with,Pers�f{=Char9e:
...
k.:4-7-
Date:
Signat r jof Person-In-Ct GI: , - I
J D /7/ 3
I Signature of InspectoYY•7 ' /////G �4,✓f
MDPH report form—10/5/18 vbrseon
Food Establishment Inspection Report - Town of Yarmouth
i
Establishment: /44,. 1� - S'ScTc�e:5z., So. S Date: •j,/ 7) Page of
Temperature Observations
Item I Location Temp(°F) Item I Location Temp(°F) Item I Location Temp(°F)
Observations and/or Corrective Actions
Violations cited in this report must be corrected within the time frames stated below or in Section 8-405.11 of the Food Code
Item Section of Code Description of Violation Date to Correct By
Number
- i+ C3r'G
m i C—c, L.00{.t1'e „olVE
Hid si (c - 0
r of Person-in-Charge:
/ Date:
Signature 9
Signature of Inspect?, ,/
MDPH report form-10/5/18�'w���