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32 CLIFTON AVENUE (FOREST RIVER PARK) SPIR 6-10-2024 r <<� CITY OF SALEM MASSACHUSETTS IV BOARD OF HEALTH Public Health 98 WASHINGTON STREET,3RD FLOOR Prevent.Promote.Protect. TEL. (978) 741-1800 DOMINIC PANGALLO health iusalem.com DAVID GREENBAUM,RS MAYOR HEALTH AGENT p p I SWIMMING POOL INSPECTION REPORT NAME:. yts+ L,VW I c n! DATE:��i,1202-4 TIME IN: ADDRESS: 52--Cf,�L), yce sic PHONE: TIME OUT:3,1`�'P CERTIFIED POOL OPERATOR: ��� �n��nrn (SSSno ) Regulations 105 CMR 435.000 :Minimum '>tandards for Swimming Pools, State Sanitary Code, Chapter V Regulation Com Hance Number Yes No Title and Description 435.03 Bathhouse: Separate sanitary dressing facilities and water closet for each sex which are well lighted,drained and ventilated- Showers with hot and cold water—Sanitary drinking water— toilet paper, soap at sink and in showers(shatter proof containers),paper towels and waste receptacle 435.06 Water Circulation and Filtration: Over-all recirculation and purification system designed recirculates and filters the entire volume as follows: • Swimming Pools—Once every eight hours • Wading Pools—Once every four hours • Special Purpose Pools (Spas)—Once every half hour Maximum design filtration for filters: • High rate sand filter— 15 gpm/ft2-20 gpm/ft2(NSF filters) • DE filters—2 gpm/ft2 • Cartridge filters—0.375 gpm/ft2 Automatic hypochlorinators required feed-rate capacity: • Outdoor Pools—Three pounds of chlorine per 24 hours per 10,000 gallons • Indoor Pools—One pound of chlorine per 24 hour per 15,000 gallons 435.08 Inlets and Outlets—All special purpose and wading pools shall install an emergency shut off switch which is accessible,working and prominently marked 435.12 Water Depth Markings—Marked on pool deck and on vertical pool wall. Four-inch contrasting color stripe dividing shallow and deep ends including ledges and steps 435.21 Permit Requirements and Pool Records—Permit posted in conspicuous location. Maintain initialed records including daily attendance, amounts and types of chemicals used daily,chemical and bacteriological tests,dates and times of emptying, cleaning, and back-washing and hours of operation of purification equipment 435.22 Health Regulations, Signs=No employee working at swimming,wading or special purpose pool shall have a communicable disease. Operator shall enforce the following for bathers: All bathers shower before entering pool- Clean bathing suits—No communicable diseases (fever, cough, cold, inflamed eyes, nasal/ear discharge)—No open sores, skin diseases or bandages—No glass • Signage at entrance of pool enclosure or in dressing room—"All persons are required to take a cleansing shower bath before entering the pool. No person with a communicable disease is allowed to use the pool". • Additional Signage for special purpose pools—"Do not use under these conditions: Alone- Under the influence of alcohol,anticoagulants,antihistamines,vasoconstrictors, vasodilators,stimulants,hypnotics or tranquilizers—Consult physician if person is elderly,pregnant,suffers from heart disease, diabetes, high/low blood pressure—Water temperature above 1040F—Observe reasonable time limits—No oils and body lotions" Easily readable large dial clock SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code,Chapter V NAME: f orr 5+ K i'y'�/ r�or DATE:6 �2 Regulation Com liance Number Yes No Title and Description 435.23 Lifeguards—Lifeguard certifications—Warning sign stating(if no lifeguard is required by Board of Health) "Warning—No lifeguard on Duty"and"Children under age 16 should not use swimming pool without an adult in attendance and "Adults should not swim alone"in four inch letters. Clothing—Lifeguards shall wear red or bright orange bathing suits, shirts or jackets with uard printed in 4-inch lettering. Lifeguards shall direct their attention to area assigned 435.24 Safety Equipment—One ring Buoy for each 2000 ft2, One rescue tube and rescue hook Lifeguard /K staffed pools shall have readily available a backboard with straps 435.25 First Aid Equipment and Emergency Communication—Provide a standard Red Cross first aid kit—Working, convenient, immediate, toll-free communication system with emergency medical services, local/state price, fire department available to staff and public at all times with instructions for,use' 435.29 Chemical Standards—Test for residual disinfectant and pH conducted four times a day(once during peak load),Alkalinity and calcium test conducted weekly. Ranges are: • Residual Chlorine 1.0—3.0 PPM Combined Chlorine 0.0—0.2 PPM • Bromine 2.0—6.0 PPM • pH 7.2—7.8 PPM • Alkalinity 50—150 PPM 435.30 Water Testing Equipment—Provide a DPD test kit for measuring chlorine/bromine and appropriate kit for measuring pH, alkalinity and cyanuric acid—Reagents shall not be more than one year old—Provide accurate,unbreakable thermometer for special purpose pools 435.31 Water Clarity—Water shall be clear(black disc on bottom of pool,clearly visible from sidewalks of pool at all distance up to ten yards) 435.32 r Water Quality Maintenance—Special purpose pools shall be drained, cleaned and refilled a f minimum of once every 14 days 435.33 , Maximum Operating Temperature for Special Purpose Pools—Water temperature not more than 104°F—Water temperature shall be tested when residual disinfectant and pH are tested 435.34 Closure of Pool—Operator shall immediately close pool until pool water conforms to 105 CMR 435.28 through 435.31 standards 435.38 General Sanitation—All pools,bathhouses and grounds shall be maintained in good repair, safe and sanitary manner. Remarks,Results and Action Taken: Swimming Pool Wadi /Kiddie Pool Spa Type: Type: Free Free Free Free Free Chlorine Chlorine Chlorine Chlorine Chlorine Combined Combined Combined Combined Combined Chlorine Chlorine Chlorine Chlorine Chlorine Bromine Bromine I x Bromine Bromine Bromine pH �� 6 pH , )H pH pH Alkalinit% Alkalinit% AlkalinitN Alkalinit N Alkaliniy Calcium Calcium Calcium Calcium Calcium Hardness Hardness Hardness Hardness Hardness SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum St andards for Swimming Pools, State Sanitary Code,Chapter V NAME: RI'yex, Po,I DATE: Remarks,Results and Actions: T� pe: T% pe: Ty e: Free Free Free Chlorine Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine H )H )H Alkalinih Alkalinit% AlkalinitN Calcium Calcium Calcium Type: Hardness Hardness Hardness Type' Type Pool t-� Pool l oq Pool Volume �a,l©D© Volume g I Volume Sand Sand Sand DE Filter Type E Filter Type E Filter Type Cartridge art ridge Z7iitridge Filter Size ft2 n T2` Filter Size ft2 ( Filter Size ft2 Minimum Minimum Minimum Flow Rate g m Flow Rate gpm Flow Rate gpm Maximum (, Maximum Maximum Flow Rate n )m `I Flow Rate gpM Flow Rate gpm Actual Actual Actual Flow Rate „ m n Flow Rate m Flow Rate gpm - T F r z Yds ` L e t i Passed Inspection: Yes EINo Re-Inspection Date: '� Inspector's Signature: Person In Charge: