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PRINCETON CROSSING POOL CITY OFSALEM, MASSACHUSI='l 1'S lu BOARD OF HEALTH 120 WASHINGTON STREET 4"FLOOR Pl1b�ICHC81 h > Prevent,Promote.Protect. TEL. (978) 741-1800 Fax(978) 745-0.343 KIMBERLEY DRISCOLL Iramdin a,salem.com MAYOR LARRv iU�nal>iN,Rs/Rr.Iis,ciao,C11-FS HF_ALTI I ACENC SWIMMING POOL INSPECTION REPORT NAME: Pr;hCZ40n DATE: G��7�� L7 —TIME IN: Oc J ADDRESS: y yJ; q:. Ofiye PHONE: IV-?gO 1= TIME OUT:q;.Sb� CERTIFIED POOL OPERATOR: DrJ Ale-Jewl Regulations 105 CMR 435.000 :Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V Regulation Compliance 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: j • Swimming Pools—Once every eight hours ,V • 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/ft' • 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 104°F— 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: Pr;VIr,,0_+0M �.To55t�1cr DATE:'�eZZ� ��'„7 7"Y Regulation Compliance 7 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 guard printed in 4-inch lettering. Lifeguards shall direct their attention to area assigned 435.24 Safety Equipment— One ring Buoy for each 2000 ft', One rescue tube and rescue hook Lifeguard 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 ,V/ kit—Working, convenient, immediate, toll-free communication system with emergency medical services, local /state police, 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: V/ • 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 435.30V 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 1 Water Quality Maintenance— Special purpose pools shall be drained, cleaned and refilled a f V 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 Wading/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 Bromine Bromine Bromine pH pH pH pH pH Alkalinity Alkalinity Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Calcium Calcium Hardness Hardness Hardness Hardness Hardness SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V NAME: Lnretnki DATE: Remarks,Results and Actions: T pe: Sze Type: Type: Free Free Free Chlorine Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine pH pH pH Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Type: Hardness Hardness Hardness Type' Type _ Pool q Pool �^ Pool Volume g J Volume g Volume g n a� Sand DE Filter Type Filter Type DE Filter Type Cartridge Cartridge Cartridge Filter Size ft' �Z Filter Size ft' Filter Size ft' Minimum Minimum Minimum Flow Rate gpm / Flow Rate gpm Flow Rate gpm Maximum Maximum Maximum Flow Rate gpm Flow Rate gpm Flow Rate gpm Actual Actual Actual Flow Rate gpm 1SoM Flow Rate gpm ��M Flow Rate gpm Passed Inspection: Yes WNo ❑ Re-Inspection Date: Inspector's Signature: Person In Charge: - CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH lu 120 WASHINGTON STREET,4,N ablicHea FLOOR Plth Prevent.Promote:Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL tramdinnsalem.com LARRY RAMUIN,RS/IiEGIS,CI-IO,CP-I,$ MAYOR H73AI;PH AG INT (� SWIMMING POOL INSPECTION REPORT NAME: I- r I n ujon l/�r^n q DATE: ��25�� TIME IN: ADDRESS: 12— e.Ydae; Dr� VB PHONE: g2L7g017&9 TIME OUT: Zf n CERTIFIED POOL OPERATOR: ye W Ic-n t� Regulations 105 CMR 435.000 :Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V Regulation CompBance Number Yes No Title and Description 435.03 athhouse: 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 ink and in showers (shatter proof container ), paper towels and waste receptacle 435.06 Water Circulation and Filt ation: ver-all rec' cu tion and p ification 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/1`12 - 20 gpm/ ft' (NSF filters) • DE filters—2 gpm/ft' • Cartridge filters—0.375 gpm/ft' 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 c or stripe dividing shallow and deep ends including ledges and steps 435.21 ermit 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 o eration 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 104°F— 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: C/e25'hIa DATE: l Regulation CompBance Number Yes JNo 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 guard printed in 4-inch lettering. Lifeguards shall direct their attention to area assigned 435.24 Safety Equipment—One ring Buoy for each 2000 ftp, One rescue tube and rescue hook Lifeguard 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 police, 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 PPMpP • pH 7.2-7.8PPM SY�o( Poo( • Alkalin 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 fie year old—Provide accurate, unbreakable thermometer for special purpose pools 435.31Water 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 Water Quality Maintenance— Special purpose pools shall be drained, cleaned and refilled a 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 Wading/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 Bromine Bromine Bromine H H H pH pH Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Calcium Calcium Hardness Hardness Hardness Hardness Hardness SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V NAME: Pfli ne2lDn Lro, <,n a DATE: S Z � , Remarks,Results and Actions: Type: Pm Type: Type: Free q Free Free Chlorine l Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine H �, 7 pH PH Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Type: Hardness Hardness Hardness Type: Type PoolA °I FIIQ� Pool q try Pool Volume JVolume l �!/� Volume San[ an Sand DE Filter Type Filter Type Filter Type Cartridge Cartridge Cartridge Filter Size ftz Filter Size ftz 1 Filter Size ftz Minimum Minimum Minimum Flow Rate gpm Flow Rate gpm Flow Rate gpm Maximum 1 Maximum Maximum Flow Rate gpm 1 Flow Rate gpm Flow Rate gpm Actual Actual Actual Flow Rate m S�Lm Flow Rate gpm Flow Rate gpm O 00 Per Passed Inspection: Yes Wo e-Inspection Date: Inspector's Signature: Person In Charge: City of Salem, Massabhusetts Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 PubHcHeatth 9mmn:.Promme,pm:¢:. Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll health@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-17-7 License For : Pool (seasonal) Date of Print 5/16/2017 Granted To: Princeton Crossing Permit Issued 5/16/2017 Address: 12 Heritage Drive Salem MA 01970 Permit Expires 9/4/2017 Location of Establishment: 12 HERITAGE DRIVE Permit Fee $140.00 Restrictions: Sunday to Saturday 11:00am to 7:00pm Late Fee $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/4/2017 , unless sooner revoked or suspended. Larry Ramdin, MPH, REHS, CHO Health Agent 04/25/2017 09:10AM 9787450343 Salem Health Dept PAGE 01101 J CITY OF SALEM, MASSACHUSETTS BoAm)of PIE v;ni P611>IiCHealth 120 WASHINGTON S'tMI,4-Ft. OX Re•en1.Premnee renu4e T'uL.(978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL 1 u a]cm.com I,n1tRx ll,,Mrorrr,RS/RFI-I,';,cHo,Cl)-FS MAYOR HnAl ni AC=h.N"1' APPLICATION FOR PERMIT TO OPERATE SWIMMING POOL LOCATION OF POOL NAME OF APPLICANT /�// /L�U __ _1 TEL MAILING ADDREss� /`/� CERT I?POO OP TOR Name /Z/�e ✓[ r� Cert#4c, 2 Fl # DATES OF OPERATION(ifnot annual): 1 �~ �f DAYS&HOURS OF OPERATION: TYPE OF POOL '. Public Semi-Public Special Purpose FEE.: $210.00 for year round pools 5140.00 fa easonal$40.04!luau-ProTrt (Please pay total with one check p yable a City of Salem) Ld mit i t transferable and mu reissued upon change of ownersbip. rd with the State Sanitary Code,before any renovations,improvement,or Equipment ebaoges are made,all plans for s submitted to and approved by the Salem Board of Real& o G hap 63C,Section 49a,I certify under the pains and penalties of perjury that 1,to my beat knowledge and belief,have a tax r s and paid all state taxes uired under the law. Date SS#or Federal Identification Number Revised SA341 poolappl i.do Chmek#Aato 7 JJ�D po 5 City of Salem, Massachusetts 10 Board of Health ¢ 120 Washington Street, 4th Floor, Salem, MA 01970 PublicHeatth Ptev<v[.PtvmO(<.Pta(eCt. Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-16-10 License For : Pool (seasonal) Date of Print 5/23/2016 Granted To: Princeton Crossing Permit Issued 5/23/2016 Address: 12 Heritage Drive Salem MA 01970 Permit Expires 9/30/2016 Location of Establishment: 12 HERITAGE DRIVE Permit Fee $140.00 Restrictions: Sunday to Saturday 11:00am to 7:00pm Late Fee $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/30/2016 , unless sooner revoked or suspended. s < @ CITY OF SALEM, MASSACHUSETTS 'qty, BOARD OF HEALTH 120 WASHINGTON STREET,4.ti FLOOR PI1I)I1C1`Ie81tIl Prevent.Promote,Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL lramdin e salem.com LARRY RA84DIN,RS/REI-IS,CHO,CP-FS MAYOR H6AL'FI 1 A(,,ENT SWIMMING POOL INSPECTION REPORT/ NAME: Pr l r s CST O P 0—(O s>S t N Ir DATE: 5 23 1 & TIME IN:q 3 '1 _1r 0-b ADDRESS: 12 4K.ITl4 6-E D r W L PHONE: 41$-3 TIME OUT: 10 3� CERTIFIED POOL OPERATOR: IJ t_, Ati o Regulations 105 CMR 435.000 :Minimum Stands ds for Swimming Pools, State Sanitary Code, Chapter V Regulation CompBance 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 1a • 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/ft' -20 gpm/ftz (NSF filters) • DE filters-2 gpm/ft' • Cartridge filters-0.375 gpm/ft' 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 It/ 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 435.22Health 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 104°F-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: C n1 v�orri c� DATE: '�-S Regulation Compfiance Number Yes No Title and Description 435.23Lifeguards—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 guard 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 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 vkit—Working,convenient, immediate, toll-free communication system with emergency medical V services, local/state police, 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 • Alkalin 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 forspecial purpose pools 435.31 1/ Water Clarity—Water shall be clear(black disc on bottom of pool, clearly visible from sidewalks of Dool at all distance—to ten ards) 435.32 Water Quality Maintenance—Special purpose pools shall be drained, cleaned and refilled a 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 Wading/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 Bromine Bromine Bromine H b H H pH pH Alkalinity O Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Calcium Calcium Hardness 1� Hardness Hardness Hardness Hardness 4 SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code,Chapter V / NAME: ` c� M DATE: Remarks,Results and Actions: T e: T e: Ty e: Free Free Free Chlorine Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine H PH PH Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Type' Hardness Hardness Hardness Type' Type Pool Pool Pool Volume g Volume g Volume 6—anaj Sand Sand DE Filter Type DE Filter Type DE Filter Type Cartridge �9 Cartridge Cartridge Filter Size ft' I + 14Filter Size ft' Filter Size ftz Minimum Minimum Minimum Flow Rate gpm Flow Rate gpm Flow Rate gpm Maximum 1 (y q p� Maximum Maximum Flow Rate m D CJ/ Flow Rate gpm Flow Rate gpm Actual Actual 235 +q Actual Flow Rate m Flow Rate m Flow Rate gpm ►J o Io 2 - 9 5126 Passed Inspection: Yes Wo Re-Inspection Date: 2—b I l Inspector's Signature: Person In Char e AO' 27 2016 09:31 AM City Of Salem 9787450349 page 1 CITY (�i� Szil�ra,ltz, M, Ss1\CFiusF�.'n s He1GWN IRUFInr Axb11CH,rr&Ith t�(I�$',1v111NCtY)y$'t'KIiP�t",d��}�!dX)ft TF,..;978)74I-1800 Rvv(979)745-11,43 ICINIBF,RL1r_X DRISCOLL hatndin(�salcm.coin llLIYOR L.11{tts ,R::Jltit� 1'I E,11:r'i I At'h:N I APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL ZyL ��/L NAME OF APPLICANTT (3 ' 'U 41/":W7 j TEL# MAILING ADDRESS EMAIL ADDRESS Name;CERTIFIED POOL OP 4TOR Name:_ Cert#: TEL DATES OF OPERATION(if not annual)_ DAYS &HOURS OF OPERATION: ` —P�C / ✓ TYPE OF POOL Public Semi-Public Special PurposeFEE: $210.00$210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Pk:ase pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improv,vont.,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. > r Pursuant to MGL Chapter 63C,Section 49a, I certify under the pains and penalties of; irjury that ,to my best knowledge and belie£have filed all state tax returns and paid all state taxes required under the law. Signature Date SS#or Federal Identification Number Revised 11120113 poolappl Wm Check k Date City of Salem, Massachusetts Board of Health R 120 Washington Street, 4th Floor, Salem, MA 01970 PublicFlealth Tel. (978) 741-1800 Fax. (978) 745-0343 Prevent.Promos Protect, Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-15-5 License For : Pool (seasonal) Date of Print 6/22/2015 Granted To: Princeton Crossing Permit Issued 6/22/2015 Address: 12 Heritage Drive Salem MA 01970 Permit Expires 9/30/2015 Location of Establishment: 12 HERITAGE DRIVE Permit Fee $140.00 Restrictions: Sunday to Saturday 11:00am to 7:00pm Late Fee $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/30/2015 , unless sooner revoked or suspended. 04/08/261.5 02:27 9787450343 PAGE 01 CITY OF SALEM, MASSACHUSETTS BOARD of HFiAl:rJ4 120 WAMUNGTON StluM.',4°^FLOOR ICiMBERLEY'DRISCOLL 'I'vi-(978)741.1800 �, ,r,� FAx(978)745-0343 NIA7OR RAh ]IN(OtIAi.I" LARRY RAM..DIN,R°/RET-IS,CHO,CP-rS HRALTTd AC;•ENT 2015 APPLICATION FOR PERMIT TO OPERATE A SWIMMING.POOL .LOCATION OF POOL ems_� �_;�t I y NAME OF APPLIC AN I /� _TEL# _ 2 t: MAILING ADDRESS 2- ��l `�'L/ �dl CERTIFIED P OL OPERA OR Name: c� {D Cert#; TEL# DATES OF OPERI,%TION(if not annual): 4` �U 7��l e�- DAYS &HOURS OF OPERATION: TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Dion-Profit (.Please pay total with one check payable to the City of Salcm) This permit is not transferable and must be reissued upon change of ownership. In accordance with,the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for stieb must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chvpter , Section 49a,I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have XSfilcd all state to paid all state taxes required under the law. ignatu c Date SS#or Federal Identification Number Revised 5/23/11 poolnppi Ldoe Check N Date /� City of Salem, Massachusetts Board of Health Pm 120 Washington Street, 4th Floor, Sale , PablicHealth Salem', Prevent. Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent E Swimming Pool Inspection Report Poal: �SVi` C(o�l _Date: (52 Address c Phone: Operator. cn Max Bathing Load: In accordance with /05 CMR 435.00 Minimum Standards for SwimminE_Pools;State Sanitary Code Chanter Y. Waal Permit Posted ealth and Showers signs Posted Health: no sick employees,no sick bathers,bathers take showers,spitting prohibited,no glass. Lifeguards:Present _Certification _Red/orange suit _"Guard"printed on jersey � _Sun block avail. _Voice Amplifier _Elevated seat Emer.Communication:phone at pool _Phone instructions _Emergency numbers Phone in unlocked area V Safet quip: for each 2000,sq. feet scue tube or ring buoy(with rope) a board with collar and straps First Aid: Equipment area _j3/ 5) 1"band-aids _9// kki))3x3 gauze q)5x9 surgipadsl _Ae )antiseptic wipes VG}8x10 Surgi 2"soft roller bandages VS 'ssors V).Z)3"Soft roller bandages weezers ��jo)'h roll hypoallergenic tape V Rescue blanket V ce packs Pocket mask _sterile isotonic eyewash �D Disinfectionfq„ . _Chlorine _pH 7.2-7.8 Residual free 1-3, Combined 0-0.2 I _Bromine �pH7.2 -7.8Residual2-6 (ppm)(mg/l) t/ Records Kept: ater tests /Chemicals Used j/Baekwashing Attendance ours of operation Depth Markings Sidewalk and inside pool vtng Boards rigidly constructed,property anchored,braced for heaviest load,no splinters or c cracks,non-slip surfaco,not over 10' above water level and at least 13' unobstr u cted headroom Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well Lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water, soap provided,no common cups,towels,combs, pool adequately enclosed,approved �r�mk,i^ng33water facilities `t Notes: r'cy' ...JL�S, t l - ��T' ewtlet VIRirJQ . Received : � Inspected by� J•�J1yA e75)L_ PRINCETON CROSSING POOL RULES On Saturday, May 23rd, the pool at Princeton Crossing will officially be opened for the summer (Weather Permitting)! To ensure the enjoyment of the pool, please take note of the following: 1. No Lifeguard on duty. Swim at your own risk. 2. Everyone must sign in when arriving at the pool and sign out when leaving. 3. Two quests per apartment will be allowed Monday through Friday at no additional charge(Max of 2 guests-no exceptions!). One quest will be allowed Saturday and Sunday at no additional charge, the 2ntl guest will be charged $10.00 (Max of 2 guests-no exceptions!). Regardless of whether you are using the pool or the pool deck, you are counted. Guests can only be accompanied by an adult resident(Age 18 years or older). 4. Residents 16 years and younger must be accompanied by an adult resident(Age 18 Years or older). The maximum number of minors one adult can be responsible for is three. Photo ID may be required to verify age. 5. Per Salem Board of Health anyone entering the pool must first use the outside shower on the pool deck. Anyone with any communicable disease shall not be allowed to enter the pool or the pool deck. 6. Running,rough play, excessive splashing, diving, or improper use of the pool is dangerous and not permitted. Residents/Guest that do not comply will be asked to leave. 7. Food, glass, breakable items and pets are all health hazards and are not to be brought into the pool area. 8. Life vests, safety rings and arm "swimmies"are permitted. All other flotation devices are subject to approval by management. Toys are not permitted in the pool area as they can get caught in the filters or tear the pool/deck liner. 9. No smoking or alcoholic beverages are permitted inside or outside the pool area. 10. For sanitary reasons, no residents in diapers are permitted in the pool. Children may wear"swimmers" as an alternative to diapers. 11. Proper swimwear is required. Residents/Guests without proper swimwear will be asked to leave. 12. Individuals with long hair must wear a bathing cap, or have hair tied back. 13. Residents and guests may use the pool facilities at their own risk. Management does not assume liability for personal injury and is not responsible for loss of personal property. 14. Please cooperate with the pool attendant as Management may suspend any person's pool privileges anytime at its discretion. 15. Items left in the refrigerator will be discarded upon closing of the pool each day. 16. No person with sores or other evidence of skin disease, or who is wearing a bandage or medical covering of any kind, will be allowed in the pool. 17. The pool is considered a family friendly environment. Residents and guests should refrain from inappropriate behavior, conversations or language while at the pool. Pool Hours (Monday-Sunday): 10:00am-8:00pm *Pool hours may vary depending on weather i CVS/Pharmacy' 426 ESSEX ST, SALEM, MA PHARMACY: 741-0484 STORE: 744-2237 i REG#01 TRN#4761 CSHR#1190825 STR#457 Helped by: SHANNON F 1 CVS ALCOHOL PADS 100 2.57T i 2.57 so 3 OR MORE 2 2.33 EACH 1 CVS EYE WASH 4 2 5.79T 2 ITEMS SUBTOTAL 8.36 MA 6.25% TAX 52 i TOTAL 8.88 MASTERCARD 8.88 ww*ww*wwwww*2960 MS DOME .00 11111lIIlIIIIIIII11111111111I! VIII 2500 4575 1344 .7610 11 RETURNS WITH RECEIPT THRU 07/13/2015 MAY 14, 2015 10:34 AM F-FLEXIBLE SPENDING ACCT SUMMARY (FSR) Health Care Elisible Total 2.73 . wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww FSA summery above includes items (and tax) that may be ellsible for Plan reimbursement. Restrictions may apply. wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww GET YOUR CVS EXTRACARE CARO THANK YOU. SHOP 24 HOURS AT CVS.COM CITY OF SALEM) MASSACHUSF 1 I"S BOARD OF FIEALTH 120 WASHINGf ON STREET,4"'FLOOR PublicIil alth Yeevortt v,amam.Prafecl. TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEYDRISCOLL bmAn@salem.com MAYOR LAIUO'HANIDIN, IS,(:IIO,(:P-pS FIG,IZ.TH AGENT Swimming Pool Inspection Report Pool:�'Rral t ~orl Csti-USS >� Date: S_)`3 _N Address it� m T\/ Phone:9 7 e, -7)s /mac, Operator:"c�Ps�a at8rxtasss Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools•State Sanitary Code 7ter�i /Annual Permit Posted ✓' Health and Showers signs Posted —Health:no sick employees,no sick bathers,bathers take showers,spitting prohibited,no glass. N)WLifeguards:Present - - Certification Red/orange suit "Guard"printed on jersey Sun block avail. Voice Amplifier Elevated seat r� Emer.Communication: phone at pool ✓Phone instructions L;/Emergency numbers i,Phone in unlocked area Y Saf ty Equip: for each 2000,sq.feet -'Rescue tube or ring buoy(with rope) -"Backboard with collar and straps _First Aid:Equipment area (35) 1"band-aids {10)3x3 gauze (2)5x9 surgipads 2)antiseptic wipes (I)8x10 Surgi (2)2"soft roller bandages �tssors (2)3"Soft roller bandages _+� Tweezers I/ )'l�roil hypoallergenic tape J Rescue blanket y e packs Pocket mask jLXsterile isotonic eyewash Disinfection ,-Ch orine pH 7.2-7.8 Residual free 1-3,Combined 0-0.2 - 7. �1 o —Bromine `pH 7.2-7.8 Residual 2-6 {ppm)(mgtl) _ ef!fRecords Kept: A-'Water tests `Chemicals Used L-�Baekwashing 4 Attendance l/ ours of operation >/Depth Markings Sidewalk and inside pool Yin Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c WL cracks,non-slip surface,not over 10' above water level and at least 13' unobstructed headroom i WLIV Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated,impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved drinking water facilities Notes: iuq�ca �U� U11hA la n�, 'T Received by 4a) Inspected by: i of Salem, Massachusetts. t " ` w 1, M, Board of.Health Tel. 978' 741-1800 Fait:`,' 978 745 0343 . e o _ Washin ton Street 4th FIodP, Salem,.MA 01970- s , , gPuCHealth H g M a Kimberle Driscoll �( ) ( , La Ramdm RS/REHS CHO CP FS v r ° ' at � Iramdirt@salern� com: " Rv a� -Mayor ear Health Agent t } s PUBLIC°POOL HEALTH �PERM�IT'' # `J:Ya ,° r >•v '§ y R � ti tyt + f ,r` n d _ $� .� 4 ., .o:� N a �ek ptx,*�. § t� .rvn ��''� �:.LlCense For " ° POOI �5@asonai� ¢' ',§ Rr• ,n e W ., ,,y- Jai ntk' k :2 „ �, i it,�.x " w 4 I ,w fP+i ,w,",. 7 A. 5 , 5 :`L > #>" ? 4 � mti r ^` � Date of ' y Princeton Crossm v e y 4N 51201�4 +'trmg{�1 k X CifHnted zTO: '''"u xt i,.r .'�,�ti"b .a Y9 ^ tdx h.:F a § .kv [ t , 2 t 3{M 6 l b "fin{• " "» 'Tbh,f J y �g pp�p,.�. I, N'r '� &� d.7l.7rF.% Sri e „y i i ,§ ,v Permit Issued 'd n ,art Drive .I " , :Salem ° y zt d! w; J" e a a,: 4MAa.m.'""x ,01970 p 4115[,2014 w', 2 He tage # a �* t xiP`xxk*, - 1 r m n '€{m d�vr 9, tlx°n , 1X" �M ;(�' ,qq',' ,�y� 4 4 �[ 5a• 1 KI f `,. v.' .x t 1 h ! a rr "{n t `4G "d 'r ✓ (p - a s*`- ' wf r.,. ` "dry :.. w x^ ' . t a+'r "{' p >�" f rU ,{ ! ty Permlt.EX IreS `'; :� h uk, n, * su. t4 ,z n w y a, x F i ,.< a r ° '� x; '� H7 .din' v a:. rekf" ,x "r A.c �; ^� r�d:3"{` ri' r t �� m L' on of Establishment 12 r, -Q 4, .,HERITAGE DRIVE ib r z3 d a� `P m 1 t 'f n"k - ^' s °�5 Jr �, vl `iti J a� 'pt F s xa f,§ ugh tYl t�r�' 2 v ''` s 4 3' +' Permit Feerq m., P a,t 4° srwy,.-^�Y ' i ✓vx„ r"k .;F' m "k 4 *�- A§ 1 � �`5t<" �t5rr d T .t"a'i xr q '� "� !^x` r ' ' Jr. ° q $140 OO 3M xk °{� ResUictioris >' Monday to Friday 11 OOam to 7 OOpm 8 Saturday to Sunday,b1 OOam to „ ^';, " .,qdm 'is,YYY yF ' 4 sus 00 m s t y r# "fY 1"^ /' 1 ;, t °'+"a�u, h.+m�,�t'�{a o rt X '!s 1R .v'v§ N w' 4{ yy 'SbM sw a §"a'y 8 ask ur a #v r k ;r s' .;aW `4k li d Lat@ r 7r' Q� ra+5 ^i ;�a a 9k r r r y$ ar , t P 1° m3§,d X`- s �,YO UU s 4 W N":T 21 ,:�,d: r 5 n ~& 4 n d . ' ''zTt dNOteSiwFfi n s ,•^ib u r r raf a'.0 ''� v k a . td� ! J i. a flf e J 1 ."''WK I 3 .'." p4Jt t 4.,r �° .3sii [° SL, 3 L { "4 ^�ea �Si -.?t,drab I`�. r 'r" 51" - 9 This permit or license is.granted in conformity With the':statues and ordinances relating thereto, and expires om 918/2013, unless sooner revoked or suspended i ,. r^f x � d J r'&vi ny !J �Ld plh C� vm�txx4aam ztx '. 3 i�� t "z§ �3� yzv: ` ; 2 s : n1 x - "+ A >r .vx . r r ' Y f g $1 y`c 9x". Ail 4M s r rr A,'Y�. 4�x 1`2p Y '"k � '� i 1` � ik . � $ �� .et s'�t.riP^4 $ G '�• a r 4 fy ;ji' .... d x ? u , yst �. f P4f> 4 Sy 1b t sijy 'iR�'p f . J% i4r 1 dS's.. ?ts r Mr k �1fi J� J �' r • 4 CTIY OF SALEM, MASSACHUSEI I'S BOARD o r Hp.AI:t 1l PubliCHealth 120 WASHINGTON S'11U i.1,4"1 Ff OOIi prevent,promote.Pr Ith ovi..(978)741-1800 FAx(978)745-0343 Ips�k4EA m E® lxamdingsalem.com KIMBERLEY DRISC©lily LARRY R,ANIDIN,RS�REHS,CL-[O,CP-P$ MAYOR APR 11 2014 Hr..,V:ri-i AGAIN C GI I`; OF SALEM HOARD OF HEALTH APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL /�pi( / l fly e C/�L NAME OFAPPLICAN7- �lg �G ,Ul TEL#�//�� MAILING ADDRESS�Zl=' EMAIL ADDRESSCERTIFZ OR Name: /J lZ/�joGG) Cert#: TEL# 77?-1 DATES OF OPERATTION(if not annual): � l DAYS &HOURS OF OPERATIONX/J TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total ' hone check payable to the City of Salem) This permit is not sferable and must be reissued upon change of ownership. In acc ordantwi the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for su(dall Wed to and approved by the Salem Board of Health. Phapter 63C, Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have fie s and paid all state taxes required under th law. 9/ - ✓ / I � S gna a Date SfS#or Federal Identification Number Rer0/13 poolappl I.doc Check#Date CITY Or SALEM, MASSACHUSETTS BOARD OF HE-M. 14 120 WASHINGTON STREET,4°'F1,OOR T>~;I,. (978) 741-1800 IQMBFRLEY DRISCOLI FAX (978) 745-0343 MAYOR tramcEn@saleAn.com salein.com LARRY RAMDIN,RS/RFI IS,CHO,(T-FS HFAI:rri AGIi:NT Swimming Pool Inspection Report Pool: i�1Z11JCtloa/ CAoSSI�� Date: S'I'3'17 Address Phone: Operator:C_Aty Fl%"W Max Bathing Load: /n accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools;State Sanitary Code Chanter V Annual Permit Posted Health and Showers signs Posted Health: no sick employees, no sick bathers,bathers take showers,spitting prohibited,no glass. Lifeguards: Present _Certification _Red/orange suit _"Guard" printed on jersey —Sun block avail. _Voice Amplifier _Elevated seat Emer.Communication:phone at pool _Phone instructions _Emergency numbers _Phone in unlocked area Safety Equip: for each 2000,sq. feet ( scue tube or ring buoy(with rope) -Lzsackboard with collar an daps First id: Equipment area Cyt ne��(35) 1"band-aids 0)3x3 gauze 5x9 surgipads kl2)antiseptic wipes (1) 8x10 Surgi v�2)2"soft roller bandages Scissors V(2)3" Soft roller bandages V' Yweezers 4(1) '/2 roll hypoallergenic tape(wud ncw� e/Rescue blanket t cc packs AA Pocket mask V sterile isotonic eyewash Disinf ction Chlorine-(,(7 _pH 7.2-7.8 Residual free 1-3,Combined 0-0.2 _Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg/I) Records Kept: `_(•8 Water tests —Chemicals Used _Backwashing _Attendance _Hours of operation Depth Markings Sidewalk and inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10' above water level and at least 13' unobstructed headroom _Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water, soap provided,no common cups,towels,combs, pool adequately enclosed,approved drinking water facilities Notes: / 1 Received by!: Inspected by� t �/ r�K+' � :. i' 1s1 , M.1 *V, ii Ali vy+ a n=6"r, � .1 rti :� S6'P C/1 _".a>e^ � .r@+ u^ffi�^a �3r +'� $4, ,� 4,• qs Os -imp ' '46 ' � tl { ywJa SRPro1 � so kpv 4% �, r u&. �• i x r : N r 'rn. 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W ex {' Y A h a m`< »'o'A+ r�ra.`>i '"C+ ;tel 'g" z 'tea a1; '' " +rM v +'" ' '��f"i ' + b: 4 � � , ,+}yfga ! y�y,,, b; 1 ,Rjr F' +.. ° � a a�' „t��3�i „,fie ♦ .Oi. t ' e .'"{,.. "li7 r� y�T'$"dY 1 �,1 ,yy yp��,y($ ti sc'dv e ��y{. .• " i s �l 4� ';^5+2 v Y�.. ✓< _ ` n a J 4 '' -. � +a {, �" m"f Yds r x r` ,,rx '�^!:. * f� r m v . ^s... a �pf 'Y i.�,� +� ,F, $� g �yq v�:+tS'.4 s .v. ,, w•R" a h J " 5� 'd& ' +t a iMAN 4. 1�" Y' 'A = IMPORTANT MESSAGE FOR `a% DATE_ S'! 2-d2a TIME �PsM. Mo OF 1�/lfiuto6"./r rs J/.�ailCG PHONE —[lU — / TUU AREA DUE NUMBER EXTENSION ❑ FAX O MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU e..._, WILL CALL AGAIN WANTS TO SEE:YOU RUSH" RETURNED YOUR CALL WILL FAX TO YOU MESSAGE _ —ii we,4i CLgonite-a� I-- /1.tI o wL..L�y� dhow.�en J SIGNED s. MAAOE IN U.S.. A r NOk�.S _ — . _Cal(,ed__ i_�n� sjia_1/�y�5 II i CITY OF SALEM, MASSACHUSETTS PublicHealth BOARD OF HEALTl-I 120 WASHINGTON STREET,4r"FLOOR KIMBERLEY DRISCOLL TEL.(978)741-1800 FAX(978)745-0343 LARRY RAMDIN,RS/RF,HS,CHO,CP MAYOR Iramdin@salem.com FS HEALTH AGENT APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OFPOOL7:j btlC_o l?i+I NAME OF APPLICANT �/ / TEL# 1 / /� MAILINGADDRESS let CERTIFIED POOL OPERATOR / Name: �/d� y �� 4/4/ Cert#: TEL DATES OF OPERATION(if not annual): /Yy`�L L/ / 5'!�eYI DAYS & HOURS OF OPERATION: — '0� Af TYPE OF POOL Gd Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 63C Section 49a, I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have filed all state tax returns and paid all state taxes required under the law. Signature Date SS#or Federal Identification Number Revised 5/23/11 poolappl Ldoc Check#Daze a. CITY OF SALEM, MASSACHUSETTS BOAS of HE,tt,TH PublicIiealth 1201VASHINGTON STREET,4"`FLOOR P[esrnt_Pmmore_i'[aietl. TEL. (978) 741-1800 FAX(978) 745-0343 KINMERIXYDRISCOLL lrarn n�a?salem.com L.V2RY annnDiN, I-Is,CI r;I'-rs MAY(:)R RL:AI ]lACI,,N'C Swimming Pool Inspection Report Pool: Rimafon Ct`O36tlyt Date: 5 I14rfl'( d'ief. gt7-8 361-7tqct Address IPhone: Gr7 ' 7410 0 Operator: c W11 0 Max Bathing Load: In accordance with 105 C.'1IR 435.00 Minimum Standards for Swimmirte Poots:State San!tary Code Chanter V. ko ayv� ry� c 'O� pun ✓ Annual Permit Posted Ih �tTr ce IS5k9 Lv` k� A(��G� n o Health and Showers signs Posted - M IS 6r �,C ,kt�5X} �r c tr�Health:no sick employees,no sick bathers,bathers take showers,spitting prohibited,no glass. - Lifeguards: Present _Certification Red/orange suit _"Guard"printed on jersey —Sun block avail. Voice Amplifier _Elevated seat t�Emer.Communication: phone at pool V/Phone instructions Emergency numbers -7 Phone in unlocked area -A/— --Safety Equip: for each 2000,sq.feet Rescue tube orring buoy(with rope) _,,/Backboard wit�i collar and straps First id: Equipment area axa Q4 (3 5) 1"band-aids- x/(10)3x3 gauze ` S (2)5x9 surgipads (12)antiseptic wipes (1)8x10 Surgi- (2)2"soft roller bandagescmt Thor , _Scissors (2)3"Soft roller bandages Tweezers (1) '/a roll hypoallergenic tape Rescue blanket Jice packs II a Pocket mask- sterile isotonic eyewash v Y�ir2e1 t _. Disinfection 5114//A `7-,j 5�i�l �� Chlorine ,J0 ZpH 7.2-7.8 Residual free 1-3,Combined 0-0.2Is Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg/1) ✓ Records Kept: ✓Water tests ✓Chemicals Used JBackwashing Attendance 7 Hours of operation -6Depth Markings Sidewalk and inside pool N Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10'above water level and at least 13' unobstructed headroom Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated,impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved drinking water facilities Notes: Received by: Inspected by: _ PRINCETON CROSSING POOL RULES On Saturday,lMay 26 , the pool at Princeton Crossing will officially be opened for the summer (Weather Permitting)! To ensure the enjoyment of the pool, please take note of the following: 1. No Lifeguard on duty. Swim at your own risk. 2. Everyone must sign in when arriving at the pool and sign out when leaving. 3 Two quests per,apartment will b'e allowed Monday through Friday at�no,addtt�onal charge(Max of �e 'guests-no exceptions!)�n One 4uest will be`allowed Saturday and�Suriday-at no additional chage,the 2;r guest will be charged $1;0 00 (Max`of 2 guests no exceptions�),; ,Regardless of whether you;are.using the.pool or the-pool deckyy_ou are counted?� 4_"Residents 16 years and younger must be accompanied by an adult resident(Age 18 Years or older). The maximum number of minors one adult can be responsible for is three. Photo ID:may be requjred to verify 5. Per Salem Board of Health anyone entering the pool must first use the outside shower on the pool deck. 6. Running, rough play, excessive splashing, diving, or improper use of the pool is dangerous and not permitted. Residents/Guest that do not comply will be asked to leave. 7. Food, glass, breakable items and pets are all health hazards and are not to be brought into the pool area. 8.„;Life vests, safety ringsandarm rswgmmies are permitted. All other flotation devices area suubiecH t to aparoval by management. Toys are not permlttecJ m the pool area as fheyxcan,get caught in the filte_rs or tear the_155ol/6qc liner. 9. No smoking or alcoholic beverages are permitted inside or outside the pool area. 10. For sanitary reasons, no residents in diapers are permitted in the pool. Children may wear"swimmers” as an alternative to diapers. 11 Proper sv✓rmwear is requ{red`Residents/Guests wdhoutproper,swimwear will be asked fo•eaye 12. Individuals with long hair must wear a bathing cap, or have hair tied back. 13. Residents and guests may use the pool facilities at their own risk. Management does not assume liability for personal injury and is not responsible for loss of personal property. 14. Please cooperate with the pool attendant as management may suspend any person's pool privileges anytime at its discretion. 15. Items left in the refrigerator will be discarded upon closing of the pool each day. 016. o person with sores or other evidence of skin disease, or who is wearing a bandage or rredical covering of any kind,will be allowed in the pool. 17'The pool js,considered a family friendly environment yResidents and',guestsshould refrain�,,from magpropriate behavior conv_ersations or_language'while at the pool,' Pool Hours (Monday-Sunday): 10:00am-7:00pm `Pool hours may vary depending on weather Pool Closing: September 3, 2012 at 7:00pm Tori Senft From: Peachtree Business Products [esupport@t.pbp1.com] Sent: Monday, May 14, 2012 11:48 AM To: Victoria Senft Subject: Your Peachtree Business Products Order x Thank you! The confirmation number for your order placed on 5/14/2012 is P2707485 . You can check the status of your order at anytime online by selecting Order Status from our homepage. Once your order is processed and shipped, we will send you by email a shipment confirmation with your tracking number. After that time, you will be able to track your order online by selecting Order Tracking from our homepage. Please tell us how we did. Your opinion matters and we would appreciate your feedback. Take a quick 3 question survey when you click here. ORDER NUMBER: P2707485 Ship To Address: PRINCETON CROSSING APARTMENTS TORI SENFT 12 HERITAGE DR SALEM MA 019702058 Qty Item No. Description Amount 1 SN R P 15 Sign 36 x 24-'Warning No Lifeguard On Duty... $106.00 1 SN R P 27 Sign 18 x 18 Persons having an infectious.... $41.00 1 SN R P 23 Sign 18 x 12 Please Shower... _ $27.00 Total: $174.00 Frequently asked questions How do I find the status of my order? You can see the status of your order at anytime online by selecting Order Status from our homepage. When will my order ship? We ship as soon as your items are ready. This can vary depending on where your items ships from, whether 1 ° CITY Or SALEM, MASSACHUSETTS BOARD OF HTv u:ni 120 WASHINGTON STREET,4°i FLOOR TEL. (978) 741-1800 KIMB) RLLY llR15COI L FAX(978) 745-0343 MAYOR Iramdinna,salcm.com LARRY RAMDIN,RS/RF'I IS,CI10,CP-PS HF.AIxii AcicNT Swimming Pool Inspection Report Pool: L,ASS\OJ\, Date: -Z�-�I . Addresstay Phone: Operator: Max Bathing Load: 1n accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools;State Sanitary Code Chapter V. nnual Permit Posted Health and Showers signs Posted Health: no sick employees, no sick bathers, bathers take showers, spitting prohibited,no glass. Lifeguards: Present yEmerCertification _Red/orange suit _"Guard"printed onjersey _Sun block avail. _Voice Amplifier _Elevated seat ommunication: phone at pool Phy e instructions tzEmergency numbers Phone in unlocked area Safet Equip: for each 2000,sq. feet Rescue tube or ring buoy(with rope) Backboard with collar and straps �Fi st d: Equipment area (35) 1"band-aids %0 (10)3x3 gauze 7(2)5x9 surgipads _, 2)antiseptic wipes K( 8x 10 Surgi �)2"soft roller bandages tssors )3"Soft roller bandages / eezers _.Z(11112 roll hypoallergenic tape escue blanket Zz Ice packs Pocket mask _jesi2rile isotonic eyewash ✓ Disim tion Chlorine —3.(o "j.) pH 7.2—7.8 Residual free 1-3, Combined 0-0.2 _Bromine _pH 7.2—7.8 Residual 2-6 (ppm)(mg/1) Records pt: � ter tests hemicals Used IR4 Backwashing _Attendance _Hours of operation Depth Markings Sidewalk and inside pool A Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10' above water level and at least 13' unobstructed headroom Bathhouse: Separate dressing and sanitary facilities for each sex, adjacent to pool,well lighted, drained,ventilated, impervious construction, one shower and one toilet per 40 bathers,hot and cold water, soap provided,no common cups,towels,combs, pool adequately enclosed,approved drinking water facilities Notes: Received by: Inspected by: pp rTao1. L Z1' I I I r ectionnfiQ�N�'�Ta� i✓�-nSSi�� Date "' Timee1'la� � }'Q� - " r , Address lei. No. i ner } Z l ra'3M n ur Type of Inspection i" Inspector { ' I Remarks and Violations are listed below: L Report Received by: Inspection_of, T ��tSL\:.�4iJ �.1�A�Sr (� %�rJey� Date S� Z� � ) Time J O'O5 01n, Name � �s,(.,� itis-� CtiQSS t c.1 - Address n Owner- Tel. No. Type of Inspection 1" ... Inspector ( ' ) Remarks and Violations are listed below: scar(K r • ,a j �G 1111 t Report Received by: ;(-t-/(r Y sf G Commonwealth of Massachusetts s t City of Salem Board of Health Kimberley Driscoll Mayor 120 Washington Street,4th Floor Ma y SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/23/2011 ESTABLISHMENT NAME: Princeton Crossing Pool File Number:BHF-2004-000195 12 Heritage Drive Salem MA 01970 LOCATED AT: 0012 HERITAGE DRIVE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2011-0440 May 23, 2011 Dec 31,2011 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES IDecember3l, 2011 Board of Health /i U Page 1 CITY Or SALEM, MASSACHUSETTS - BOARD or HeAU11] 120 WASmNGTON Sraels 1,411FLOOR T7a1,.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGRecNBAumi@sA[.cmt.COM DAvI D GREEN BAW i,RS AU17NG HEM.n-I AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 2 & W % - NAME OF APPLICANT o ( TEL# MAILING ADDRESS 1Z 9d*:[ 6//��? f/ 70 CERTIFIE 00 O RATOR Name: o u/�,n Cert#:U/-29J30S TEL# V-V-V-0 _176J0 DATES OF OPERATION (if not annual): 5V /I — DAYS & HOURS OF OPERATION: M- r lo- rInm�AT II Id 10 -�Pf, TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.0 f r seasonal$40.00 Non-Profit (Please pay total with one check paz-0 City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pur t MGL Chapter 63C, Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have fi 11 to t r s and paid all state axes required under the law. V �2//l tom-346'-sZo Signature Date SS#or Federal Identification Number Revised 10/6/10 poolappl Ldoc Check# Date /` h C 4ettilied ftvrt 1 Spa O(uavort Nr/r> . iCr, ' �IYfLl�y�.,,/�1'Nfrl�6k3U.ii tt.�em n�ay.emm�c�acrz:n.r- eeCH Reslemuan rva ii3.-Gf1 i_'p,S ,Is nercey cenmea vw Flegi9mrea M nm NATIONAL SWIMMING POOL FOUNDATION oq i/f e(A1 DATE CERTIFIED INSTRUCTOR ¢ C.E.O. p�o SpAU I i f Inspection of ?9,) Nl.:-.r�� CA-4S S 103 l,, ��' Date 5-19 O Time 0' 36 Name Address Owner Tel. No. Type of Inspection Inspector�• rd;SJ�6h/r� I �'•S/4lilh�� ( � 1 Remarks and Violations are listed below: 1=I �z\� 1 s ►->•, �ss)iz�l S C S So12S V/ 76 R- ?bo\ NCO 71D T�:, w FoN 2oP�-, J� F S I: 14 awl -� �r�i l c�� l � �ac� t� C `�L sw 1 t✓n�,j ,J �;l - a l r < J-d_ n Report Received by: /,�,/1e—W c/.� Inspgction of - 1 tJ C,r. Date 5 Z� G Time Name Address Owner Tel. No. Type of Inspection Inspector 'J• �l:-:f:"��l'�r'�•- I �j/t t,r.:��'t-.E1� ( ' Remarks and Violations are listed below: Qt 5t 1e, S _ � '� �. ' '�C^1�� it ��_•rif SJ h1. "P' i_,i , n Ite MMc. I oh - 1� coatcfred ex&eofcoat �ckQ.t Irna. --� b � o �.ti�t issued / Report Received by: z ` CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WAST IING"I'ON S'1REE'r,4m FLOOR TEL.(978)741-1800 KWBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGRECNBAUntna SALEM COM DAVID GREENBAUM, ACTTNG HEALrLt AGENT 2009 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL NAME OF APPLICANT TEL# MAILING ADDRESS CERTIFIED POOL OPERATOR Name: Cert#: TEL# DATES OF OPERATION (if not annual): DAYS &HOURS OF OPERATION: TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code, before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 63C, Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belie$have filed all state tax returns and paid all state taxes required under the law. Signature Date SS#or Federal Identification Number Revised 8/14/07 poolapp.wpd Check# Date 05/19/2010 23: 20 9787450343 PAGE 01/01 CITY OF SALEM, MASSACHUSE'I"I'S BOARD Or MiAt771 120 WAST IINGTON STREET,4"'FLOOR TEL(978)741-1800 KIhMW EY DRISCOLL FAX(978)745-0343 MAYORL=ARLNM&um(a),sAiEm.COM DAvID GrREENBAUM, ACTING 14F.ALITI AGP.NT 2009 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL e— A4, e NAME OF APPLICANT �1��l�liY1l GO TEL#_ 70D l��O MAILING ADDRESSCERTIFIED POOL 9PERATQR �lo�� Namc: �� W-h /I(�/w� Cert#. TEL# DATES Or OPERATION (ifnotson al): A /ZV/U DAYS &HOURS OF OP N: TYPE OF POOL Public Semi-Public SpCCl81 Purpose FEE: $21.0.00 for year round pools $1.40.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Mom) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of ealth. Pursuant to M pter 63C,Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief have filed a M ""I"and paid all stato taxes required under the law. a Date SS#or Federal Identification Number Rcviaed 8/107 poolapp.wpd Check 0 Date rJ i CZTi OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 S IhTMMNG OOL INSPPEC11_ON REPORT' Pool: — r Y� r t t'1 _^— Date: Address: Phone: Operator: Max. bathing load:___ in accordance with 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code: Chanter V. -ANNUAL PERMIT POSTED e -HEALT1l and SHOWER SIGNS POSTED ( -HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. - LIFEGUARDS: Present —- certification i- red/orange suit "guard" printed on jersey -sunblock avail. _ voice amplifier elevated seat MER CC CATION: phone at pool 'i phone instructions emergency numbers phone in unlocked area - SAFETY EQUIP.: f ch 2000 sq. feet rescu' j�ype or ring buoy (with rope) backb and with collar and straps FIRST A1Ti�uipmem area r _ -(3 5) 1" bandaids k10) 3x3 gauze e./-(2) 5"x 9" surgipads V--- I) 8xI0 surgi 2" soft roster bandages scissors _ (2) 3" soft roller bandages tweezers 1) 1/2" roll of hyperall rgenic tape rescue blanket ce packs d (12) antiseptic wipes *m cket mask _ (1) sterile isotonic eye wash v//DISINFECT" N l,a? _- chlorine pH7.2 - 7.8 Residual: free 1-3, combined 0-02 _- bromine pH 7.2 - 7.$ Residual: 2-6 (PPM) (mg/1) RECORDS: ept �� ya water tests chemicals used - backwashing - attendance ,hours of operation DDEPT14 MARKINGS: sidewalk and inside pool ,�1 1V ING BOARDS: rigidly constructed, properly anchored, braced to[ heaviest load, no splinters or cracks, non-shp surface, not over 10' above water level and aticasi 13' unobstructed headroom. V/� BATHHOUSE: scperatc dressmg and sanitary facilitics for rich scx -adjacent to pool, wdf hgh.cd.dramcd. Ventilated,impervious construction,one shower and one toilet pa 44 bathers,hot and cold water,soap provided no common cups, towels, combs pool adequately enclosed approvol drinking water facilitics received by: inspected by �l.� ✓j� l- (Lfi�,1G /LSM Commonwealth of Massachusetts City of Salem Board of Health 120 Washington Street,4th Floor 10mberiey Driscoll. SALEM,MA 01970 Mayor --- - - - --Swimming-Pool Seasonal Permit - - -- - DATE PRINTED: 05/21/2010 ESTABLISHMENT NAME: Princeton Crossing Pool File Number:BHF-2004-000195 12 Heritage Drive Salem MA 01970 LOCATED AT: 0012 HERITAGE DRIVE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2010-0429 May 21,2010 Sep 7,2010 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES September 7, 2010 Board of Health Page FROM FAX NO. Mar. 19 2008 01:28PM PI p4�Slyt�� 4775 Granby Circle + Colorado Springs,CO 809193131 719.540.9119 - 719.540.2787(FA)Q + www.nspf.org A nun profit foundation encouraging healthier living through aquatic education and research Congratulations on cumWleting the requirements for becoming a Certified Pool-Spa Operator`)! Your CPO certification is valid for a period of ave years from the date of certification. At that time, you will be required to successfully complete another CPOO certification class in order to maintain active status, As a graduate of the CPO�1 certification program,you will be performing a public service by operating a safe, clean, efficient, and economical aquatic facility. The National Swimming Pool Foundation'has confidence that you will do an excellent job in performing your duties. Please remember that complaints from health officials, resulting in disciplinary or administrative action taken against you, may result in suspension or loss of CPe certification. In order for us to maintain our communications link with you;please inform its as soon as possible of any change in your address,telephone, or a-mail address. You may contact us at: National Swimming Pool Foundation 4775 Granby Circle Colorado Springs,CO 80919-3131 719.540.9119 (Telephone) 719.540.2787 (FAX) cpoprogram@,uspf.org(E-Mail) Don't forget to checkout the NPSFW web site (www.nsnf;org) on a regular basis for up- to-date information on educational products and industry news. Good luck on a bright and sparkling future! Please do not hesitate to let us know if we may be of assistance to you in any way. Sincerely, CurtiGrtJ feel!uun pyy.hnrr. Thomas M. 1..achocki, Ph.D. rk Chief Executive Officer a�r1,10065�� "�� i�unrw..,wasyr;m,•d NN7oNAL SWIMMING Poul.W 1ONUAaoN nn xxnros DIM C66TMIED F ,TkU nC1Uk �"]s� C.x.n. L it Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 07/09/2009 ESTABLISHMENT NAME: Princeton Crossing Pool File Number:131417-2004-000195 12 Heritage Drive Salem MA 01970 LOCATED AT: 0012 HERITAGE DRIVE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2009-0500 Jun 15,2009 Sep 7,2009 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember7, 2009 Board of Health 17 74 Page 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HiEAL H 120 WASIQNG'IDN S'IRliie'I,4""FI.00R Tei-(978)741-1800 KIMBERLEY DRISCOLL - FAx(978)745-0343 MAYOR IMANCINI&AU:M.COM .JANI.I•M.ANCINI, Ac'nNG HH AIA1 i AGENT 2009 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL � O�J�/�� NAME OF APPLICANT p ss�� TEL# 5; jZ ,ZW`�©� MAILING ADDRESS ze , � e�e f�L�i CERTIFY POO 9PERAT```O��/R y © y ) Name:,O/�Wi /��N1 ,f�h/C� Cert#:�J/ /4 L# DATES OF OPERATION (if not annual)..— DAYS &HOURS OF OPERATION: Q TYPE OF POOL etV 411 C�tMbrf� hea f'��1�s� Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be sub 'tied to and approved by the Salem Board of Health. Purs to Chapter 63 , Sec/on 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief;have fil a s e e ai Il state taxes re uired under the law. 2/ Qf 6V JI965Z o Si ature Date SS#or Federal Identification Number Revised 8/14/07 poolapp.wpd Check# Date CITY OF SALEM, MASSACHUSETTS • • BOARD OF EIL"-\imt 120 WASHINGTON STREET,4."FLOOR TF1.. (478) 741-1800 KIMINERLEY DRI,SCOUL FAx(978)745-0343 MAYOR JMANC1N1 tiyLFNICON1 JANU',TNLNN( ]N1 ACTING 1'1t A1_X1 i AU'INT Swimming Pool Inspection Report Pool: } Na�AlaiaN� � S�ia�kr Date: �,- iN.CS Q Address 12. N)T,- PhoneU�8-`7 N o -1-lam Operator:8R R]�j 1 l� aS_Max Bathing Load; Irt accordance with 0 CMR 435.00 Minimum Standards for Swim minr Pools:State Sanitary Code Chapter V. ,ftnual Permit Posted realth and Showers signs Posted Health:no sick employees,no sick bathers,bathers take showers,spitting pprohibited,no glass. Lifeguards:Present _Certification _Red/orange suit _"Guard"printed on jersey _Sun block avail. _Voice Amplifier Elevated seat Enterr ommunication:phone at pool done instructions '---Emergency numbers ✓Phone in unlocked area Safety Equip: for each 2000,sq. feet _Rescue tube or ring buoy(with rope) _Z _Backboard with collar and straps First Equipment area r/ (3�)X'band-aids 0)3x3 gauze /{2) 5x9 surgipads (k2)antiseptic wipes /(i)8x10 Surgi )2"soft roller bandages 4- S issors ✓(2)3"Soft roller bandages eezers c/ )1/2 roll hypoallergenic tape _Rescue blanket t�o`packs ¢ Pocket mask a/sterile isotonic eyewash LX isinfec n !Chlorine _pH 7.2-7.8 Residual free I-3,Combined 0-0.2 —Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg/1) ftecor Kept: /� ter tests Chemicals Used WVBackwashing _✓Attendance •✓f Iours of operation Depth Markings Sidewalk and inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c rocks,non-slip surface,not over 10'above water level and at least 13' unobstructed headroom Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,we11 lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved drinking water facilities Notes: sda -�avL� t�113 .��gU1 �'roN\ n�, Sti-J-Iokz� sa•s^ Received by: Inspected by: RENOSYS CORPORATION PRODUCT SHEET PLEASE INDICATE COLOR CHOICE ye I .v RenoSys 60 Mil Smooth RenoSys 60 Mil Pebble for Walls for Floor 3' to 5' A I)\VC WELL ym rt{ # v RenoSys 60 Mil Del Rio Walls and Floor for Steps 150 mil. RenoFelt RenoSys Duralast System for Racing Lanes, Targets, Break Lines and Step Accents Copra eck wrap . Rec 60 Mil RenoSys Corp. 2825 East 55'h Place CM/' n� Typical Product Sheet 4:00 Indianapolis, IN 46220 RenoSys Detail Not to Scale — 0 1990-99 ARS Inc1-800-783-7005 Rev All Rights Reserved f A typicalRenoSys PVC Pool Sh 11 3 4 Installation Y The Free Floating "Shell Within Step 1 The first step is surface prep.The pool should be AShell" Concept — broomed or washed clean and all depressions, A spal led areas,and pitted areas are patched with Understanding Why vinyl concrete patch compound. r M Y It Works So Well. PVC liners/membranes are so successful at solving pool problems due to the Step 2 installation process and the way all of the components work together to create Next,a n a nti-fungal agent is sprayed over the , entire surface of the pool to inhibit algae and a proven, durable, watertight system. fungal growth behind the membrane. ' A membrane of reinforced PVC is hot air welded together inside the old pool ift n completely eliminating:leaks,the need to paint,plaster,caulk sandblast,scrape or hassle with the old shell's problems. Because the membrane system is completely suspended inside the old Step 3 shell and does not depend on a bond An adhesive is then applied with a roller to hold with the old pool,PVC is unaffected by the felt slip sheet securely in place and to keep it expansion/contraction and freeze/thaw from sliding or shifting under the membrane. problems like conventional renovation options.PVC has a non-porous surface t r � making it difficultforalgaeto adherethus +. reducing the amount of seasonal and daily cleanup.PVC also makes concrete I construction cold joints watertight Step Q allowing reuse of significant portions of The felt slip sheet is rolled into place over the adhesive. existing infrastructures. It is trimmed to butt fit and to isolate and protect the membrane from the pool surface. I Note.Although concrete is shown in this example, PVC can be applied over aluminum,steel,file and fiberglass as well. f "4 . ��ft-. Step 5 1!e.4w" i it Finally,the reinforced PVC membrane is rolled into place and welded together to form an envelope inside the old pool shell.lt g44 is adhered at the outer perimeter of the pool and in sloped areas _ > with a waterproof adhesive.Since it is not adhered to the pool shell, 4 3 it will stretch in response to pool freeze/thaw movement.Racing +. lanes,markings and targets are then welded over the PVC to finish *. + off the installation. t r ® � VJ * RenoSys 800.783.7005 • www.reno'sys.com • infogrenosys.com ®1990-200'/AR5 C({ RenoSyS' PVC Pool Shell Product Data and Technical Information Cutter trough _ 60 mil.RenoSys reinforced PVC pool memJrane.(Adhered with PVC adhesive to the fleece on the wal s,in dive hopper(as needed),and around the perimeter of the floor) 150 Mil.(11 oz.)RenoFelt separator fleece. (adhered to surface over antimicrobial sanitizing agent.) Waterline Fastener Schedule — - — ° - Appropriate fastner with Concrete Stainless Steal screw with Bantam plug. a bantam Aluminum Nylon 1/4"2C phillips flat head 1/2". Steel Stainless Steel 1/4"20 phillips flat head 1/2". PVC Compression bar with snap-in cap Compression Flange 74 For circular penetrations:1/4" Hard PVC(shown) °r6O nocaulk For rectangular penetrations:PVC compression bar with cap,comers to be mitered or 1/4"rigid PVC Plate may be used,with eased edges. ° il.RenoSys reinforcedPVC pool membrane.(Adhered Stainless Steel fastener(see Sponge gasket fastener guide above) PVC.adhesive to the Fleece on the walls,in dive or RenoCaulk.a sneeded daround the n eter of the floor Into 1/4" hole drilled 3"on p r(a ),an pe'm center in pool Floor or wall. ° mil.(11 oz.)RenoFelt separator fleece.y adhered to surface over antimicrobial agent) Concrete Penetration Existing Floor or."• Dimensions wall an oral vary This detail used at new or existing: Typical Concrete Wall Termination Main drains,lights,inlets,wall anchors,rail posts,etc... Typical Underwater Penetration Flange Condition Existing or new wall 60 mil.RenoSys reinforced PVC pool membrane.(Adhered with PVC adhesive to the fleece on the walls,in dive S Lliner (as needed),and around the perimeter of the floor) mil.(I oz.)RenoFelt separator fleece.(Adhered to Technical Data. over antimicrobial sanitizing agent) Overall Thickness: 60 mil adhered to felt Seams: Lap welded Method of Installation: Adhered Surface Texture: Smooth or Textured trips may be used under the liner to mechanically fasten or weld Warranty: 10 years place when installing in steep areas.Racing lines are adhered and Colors: Lt.Blue,Caribbean BlueWhite, Polymer Bond coat applied to the surface of the PVC membranePebble Rack,Marble,l"Mosaic Tle . Delivery: 1-4 weeks 2"min.overlap antlSeam seal solution. w, tied zo (all seams) (1"min.witla Design and Application Guide. , RenoSys complies with all applicable local,state and national codes. Roll size 6'x 82.5'x 60 mil thick.Material is manufactured with polyester Note:Installer may ran floor membrane - reinforced for maximum puncture resistance,soil guard acrylic top coating, over wall membrane where preferable. anti-fungal agents and is formulated specifically for the pool environment. Three textures are available.Request bid specif cations,product usage Typical Wall to Floor Junction guidelines,ASTM test data and construction details.Full A/E design assistance is available.The Renosys PVC Pool Shell is warranted for a full 10 years from the date of installation. Ordering Information:When ordering or requesting a quotation for the RenoSys PVC Pool Shell System,call 1-800-783-7005.Please have the square footage of the area to be covered when calling.We will review your oarequirements,provide pricing,and make installation recommendations.Awritten proposal,installation shop drawings,samples and details will then beRenoSys provided for your approval. 2825 E.55th Place,Indianapolis,IN 46220 800-783-7005•www.renosys.com Note: Field verify all dimensions 3l)�_�,� - Denotes 4,020 sq. ft. prior to installation. Existing — I30BDth eras — _—' of Rotes 4, membrane sub-straight surface concrete system (Lt. gray) with fiberglass over-lay — I l � -r--- ------f — 12'-0 Deep - f T 1 I /— Pool perimeter N 4"Black break line Oi j� 5'-0 Deep O, p 0 O I I � — 2"Color contrasting / step nosing C ] �I MI C7 -I - 24"Coping wrap (Dark gray) /'-0_O3Deep 1 - — ,I I :I I Deck Layout RenoSysProject: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: 3248-1 Scale: N/A Indianapolis, IN 46220 Origination Date: 4/27/09 Item #: 1 of 13 Phone: 317-251-0207 We reserve u e 19 b mod2009 Retails N1 RIU,a:icesew, Fax: 317-251-0360 w�n,�em rea�,esso.:oos ARS InC a�a,v?e,Ar,erv� Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) I— New or existing wall 60 mil. RenoSys reinforced PVC pool membrane. (Adhered -_- with PVC adhesive to the fleece on the walls, in dive hopper (as needed), and around the perimeter of the floor) I i _ 150 mil. (11 oz.) RenoFelt separator fleece. (Adhered to ' surface over antimicrobial sanitizing agent) Al" fTie down strips may be used under the liner to mechanically fasten or weld the liner in place when installing in steep areas. Racing lines are adhered and welded or Polymer Bond coat applied to the surface of the PVC membrane as detailed. aal, ------ - -- 2" min. overlap and Seam seal soluticn. welded zone (all seams) (1" min, wide welds) Note: Installer may run floor membrane over wall membrane where preferable. Typical Wall to Floor Junction RenoSysR Project Date: 4/27/09 Princeton Crossing Apartments c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L101 Scale: N/A Indianapolis, IN 46220 Origination Date: 11/20/06 Item #: 2 Of 13 Phone: 317-251-0207 Fax: 317-251-0360 `s ryuic 19961009 AG$Inc,/li F:��IS RP.PrvN Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) 60 mil. RenoSys reinforced PVC pool membrane. (Adhered with PVC adhesive to the fleece on the walls, in dive hopper (as needed), and around the perimeter of the floor) —150 mil. (11 oz.) RenoFelt separator fleece. (adhered to wall over antimircrobial sanitizing agent) [-Aluminum drive rivet fastener at 2'-0" on center. I I �20 Gauge galv. steel or plastic strip. i - Crack or expansion joint. I // MI\ , \l Existing Concrete Floor and Wall Expansion Joint Detail RenoSysProject Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L102 Scale: N/A Indianapolis, IN 46220 Origination Date: 11/20/06 Item #: 3 Of 3 Phone: 317-251-0207 Fax: 317 251-0360 We 1 o11", ms� l n9h 1.m� a , ,:-„„�in,„c u req&e1990.2009 PPS Inc,AIuiynIS ReseNM Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) 60 mil. RenoSys reinforced PVC pool membrane. (Adhered with PVC adhesive to the fleece on the walls, in dive hopper (as needed), and around the perimeter of the floor) 150 Mil. (11 oz.) RenoFelt separator fleece. (adhered to surface over antimicrobial sanitizing agent.) Fastener Schedule Concrete Stainless steel screw with 10-12 Bantam plug. Aluminum Nylon 1/4" 20 phillips flat head 1/2". Steel Stainless steel 1/4" 20 phillips flat head 1/2". Compression Flange For circular penetrations: 1/4" Hard PVC (shown) For rectangular penetrations: PVC compression bar with cap, corners to be mitered or 1/4" rigid PVC Plate may be used with eased edges. Stainless steel fastener (see _ Sponge gasket f_— fastener guide above) or RenoCaulk. Into 1/4" hole drilled 3" on center in pool floor or wall. �7 Penetration I ji I Existing floor or — wall material . 8 �l Dimensions • a vary This detail used at new or existing: Main drains, lights, inlets, wall anchors, rail posts, etc... Underwater Penetration Flange Condition ® Date: 4/27/09 RenoSys Project Princeton Crossing Apartments c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L104 Scale: N/A Indianapolis, IN 46220 Origination Date: 11/20/06 Item #: 4 Of 13 Phone: 317-251-0207 e e„gn om�n°e h"m" Fax: 317-251-0360 °�s.<,, "N,ae:erv� Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) Deck Top of deck Field confirm imension Face of wd all - End wall I I target marking 12" 12" 12" 36" Racing line marking Floor of pool T- End of Pool View Plain View T Racing lane markings and end wall target markings bonded and welded or Polymer Bond Coated over 60 mil. PVC as per United States Swimming (USS). (or other governing body rules). Racing Lane and Target Markings RenoSys Project: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L106A Scale: N/A Indianapolis, IN 46220 Origination Date: 1/21/08 Item #: 5 Of 13 Phone: 317-251-0207 Fax: 317-251-0360 we,IlonsI ,1991209ARiIncAJ5 mnwions�rymre.t9962099 AHS Inc pl,Tgnb ReservN Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) Large pumpout shall be used in pools greater than 6' deep. Pumpout shall be installed at the lowest point in the pool near the main drain. r1/4" PVC plate w/1/4'I legs Felt --, 1-60 mil. RenoSys reinforced PVC pool membrane. (welded over or under floor material) f-Removable 1-1/2" Dia. screw plug (ABS) I 1lllllllllll=_1777_77-1 4 4T j °° III a Existing Floor or Wall I ° II lJ ° ° "" Emergency Large Pumpout Assembly RenoSysProject: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L107 Scale: N/A Indianapolis, IN 46220 Origination Date: 11/20/06 Item #: 6 Of 13 Phone: 317-251-0207 We,¢serve u,l19IO200ily JeiaJx All RighlsR Me,e Fax: 317-251-0360 cOnOilions,quirt 19903009 ANS Inc,All N�gMs NeservM Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) Small pumpout shall be used in shallow pools less than 6' deep. Small pumpouts shall also be employed in the shallow end wall of all large pools as an air release assembly. 1/4" Square PVC plates with tapped hole. 60 mil. RenoSys reinforced PVC pool membrane. (Welded to plate and wall material) i Stainless Steel truss head bold 3/8" min. Felt I I 1 ° Existing Floor orM/all ., f 2" min. Weld zone rl 1 entire perimeter of plate Emergency Small Pumpout Assembly RenoSys' Project: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L108 Scale: N/A Indianapolis, IN 46220 Origination Date: 11/20/06 Item #: 7 Of 13 Phone: 317-251-0207 Fax: 317-251-0360 coM:IlonS:Muire 19903009 APS Inc.Ae Iip;nx fleservM Note: System includes antimicrobial agent and RenoFelt adhesive 24 (Not Shown) — -- — _ RecDeck Membrane hot air welded to PVC coated metal RecDeck Adhesive to adhere \.\ fastened with drive rivets membrane to deck and coping. I Caulk Joint —7 *Verify deck over hang - 1 n a VExistin deck zn G 1 , Coping Existing a G 4 � hv Pool Wall Fasteners M —PVC coated metal New cut in existing concrete deck Q I PVC membrane liner \—Existing wall Liner to RecDeck Coping Detail RenoSysProject: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L130D Scale: N/A Indianapolis, IN 46220 Origination Date: 4/1/08 Item #: 8 Of 13 Phone: 317-251-0207 Fax: 317-251-0360 �a ,a„s,ro�,��,1so.2W9:�9Aa51,��.allx,al Note: System includes antimicrobial PVC Membrane Liner-- agent and RenoFelt adhesive (Not Shown) RenoFelt---� � u Appropriate fastener with bantam Stainless Steel Fastener With Existing Wall � / o PVC Compression bar -- I.1� — X Bantam Anchor� v with snap-in cap d o a Caulk `- ° o Q i Recessed Step a Caulk— PVC Compression bar i v with snap-in cap Appropriate fastener with rn bantam J ° a RenoFelt y PVC Membrane Liner Recessed Step Termination RenoSysProject: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L136 Scale: N/A Indianapolis, IN 46220 Origination Date: 10/13/07 Item #: Q of 13 Phone: 317-251-0207 Fax: 317-251-0360 rel e,19 amoane lai:, .,o yMee,e Cv Wrlione icyuie 1990$009 ARS lnc,All Riy:rla FeServW Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) "c I I New or existing wall 4" Break line (black) I � Break Line Detail RenoSysProject: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L139 Scale: N/A Indianapolis, IN 46220 Origination Date: 3/27/08 Item #: 1 Of 13 Phone: 317-251-0207 We esene le,lgll to mWty Jvlaib wiNOW notice MLc Fax: 317-251-0360 onmuJnc.awe+sso.iaw ans m.nv ag,;.n�n.J Note: System includes antimicrobial agent and RenoFelt adhesive (Not Shown) - -- Contrasting black PVC membrane at step nosing Tread PVC liner membrane on step treads and risers a ° °^ 2l I ) ° % Q^1 W I ° a ° iZIO�i'Z�^Lrl./lLdrr.:�i%<'i lei<i«5. NI a 1 ' ^ - a A4 a !I ^ TypicalStep Liner Detail RenoSys Project: Princeton Crossing Apartments Date: 4/27/09 c o r p o r a t i o n Salem, Massachusetts #3248 Drawn by: KJ Appr'd by: 2825 East 55th Place Drawing #: L144 Scale: N/A Indianapolis, IN 46220 Origination Date: 3/27/08 Item #: 11 Of 13 Phone: 317-251-0207 Fax: 317-251-0360 11999tUo.2009 RROS waInan,m,laire,sHie� Note: System includes antimicrobial agent and adhesive (Not Shown) i i I —85 mil PVC RecDeck membrane system fully adhered to surface 3" I I ... . ...... .t, ° ° n a Deck 4 a 1 y Q Typical RecDeck Weld Detail , Date: 4/27t09 Renosy Project Princeton Crossing Apartments Drawn by: KJ Salem, Massachusetts #3248 Ap?r'd by: 2825 East 55th Place Drawing #: RD110 Scale: N/A Indianapolis, IN 46220 Origination Date: 10/25/07 Item #: 12 Of 13 Phone: 317-251-0207 no rosohc me Gyn m moatyaermh wnFx:nuumwnere Fax: 317-251-0360 a r<r9�.z�9Aas ..aa,o., ae.«ry Note: System includes antimicrobial agent and adhesive (Not Shown) --85 mil PVC RecDeck membrane system fully adhered to surface and hot air welded Color match caulk-- to PVC coated metal c I ° r Concrete Deck" I" L_I A —PVC coated metal fastened with appropriate fasteners at 6" O.C. L-Stop RecDeck Termination Date: 4/27/09 Reno VS Project Princeton Crossing Apartments Drawn by: KJ c o r p o r a t i o n Salem, Massachusetts #3248 Appr'd by: 2825 East 55th Place Drawing #: RD112 Scale: N/A Indianapolis, IN 46220 Origination Date- 10/25/07 Item #: 13 of 13 Phone: 317-251-0207 w< <.< Fax: 317-251-0360 anro c�m,e 199c NO nas euagne a<s<rvm Reno Sys® Corp oration 2825 East 55' Place Indianapolis, IN 46220 Phone: 317-251-0207 Fax: 317-251-0360 Submittal Package Date: April 27111, 2009 Project: Princeton Crossing Apartments Salem, Massachusetts Sold to: Princeton Properties Lowell, Massachusetts Submittal Requirements Revisions ❑ Not approved, resubmit as noted D-pproved, as noted Date: ❑ Approved, release for fabrication Date: and/or shipment immediately Date: Please date & initial each revision dOther: Nat tiT �-c w NO Rqun4 LaNC-S oR TY�2Rt,gri owe vl5r, EfLE WISL fir 10TH ( tt RXVVAS M.o• A' II T1K ( ottnq O, A. PDaL W4"5 Approved by: Q• "w �2 rcr Date:��8�� The attached information provided herein are based on our understanding and interpretation of the details and specifications. Please review, comment accordingly and return two (2) copies. Should an item require additional information or clarification, please indicate such on the returned submittal. RenoSys Typical Details Index of Drawings Detail Number Detail Title Brochure #100 Product Sample Sheet Typical Membrane Layered View 1 of 13 Deck Layout 2 of 13 Typical Wall to Floor Junction 3 of 13 Floor and Wall Expansion Joint Detail 4 of 13 Underwater Penetration Flange Condition 5 of 13 Racing Lane and Target Markings _.. 'N/,q- 6 of 13 Emergency Large Pumpout Assembly 7 of 13 Emergency Small Pumpout Assembly 8 of 13 Liner to RecDeck Coping Detail 9 of 13 Recessed Step Termination 10 of 13 Break Line Detail 11 of 13 Typical Step Liner Detail 12 of 13 Typical RecDeck Weld Detail 13 of 13 L - Stop RecDeck Termination r #" !� -'[�'•ry n r. �1✓.t le A��.4 f sr � f' Flt 4, , � . whit Zi, 44 li• ti :f'r ♦' '. e'er '�,�.� r5�r.��`t .r y - t a A .4e n 0v s PVC ,Tool Shells before s s J... L a er x R V Aquatic systems That work. Durable, Low Maintenance, "' Flefible and watertight. RenoSys Corporation is North America's largest, oldest and most respected manufacturer, I RenoSys xthe ideal surface for the interior lining of new or existing public pool structures. distributor and installer of polymer productsConstructed on site from a 60 mil reinforced designed and formulated specifically for public membrane of specially formulated PVC, RenoSys is swimming pool construction and renovation. textured to provide nonabrasive slip resistance, is g P pore free for ease of maintenance,and offers From the RenoSys PVC Pool Shell to the dependable water containment for deteriorated DuraTech Pool Gutter or Grating Systems, pools which are experiencing water loss.RenoSys offers remarkably cost effective options for new RenoSys is committed to meeting the needs of * �* - pool construction and is usually dramatically less public and commercial swimming pool designers, expensive than conventional renovation options. operators and managers. Featuring a full p ria network of licensed contractor applicators, RenoSys has handled projects on all continents. ��R°�� PVC has become the standard in the aquatics 1t UfY+x' • industry for pool piping systems due to its low maintenance, its affordability and total f imperviousness to pool chemicals. The RenoSys r ' Corporation family of products brings all of the The RenoSys system upholsters the pool with a advantages of PVC to pool surfaces. durable watertight easy to clean membrane. RenoSyS Fives old pools and Permanent Impermeability. J RenoSys PVC Pool Shells are specifically Aluminum and Metallic Pool formulated and designed to provide an effective v " Problems solved. water containment membrane for use in any " public pool application. RenoSys commercial �° u • ' The special problems experienced in aluminum and liners have been successfully employed in pools mild steel pools due to galvanic or electrolytic corrosion are effectively eliminated when RenoSys is installed. constructed of concrete, steel, fiberglass and Since PVC is an excellent insulator,the electrical aluminum. RenoSys offers special electrical currents in the body of water are prevented from isolation benefits for problem aluminum pools and contacting the metal wall by the 60 mil PVC barrier. other metallic pools. RenoSys may also he used Hundreds of aluminum installations have proven that RenoSys prevents pool side corrosion in metallic pools. to line fountains, water features, or for site built potable water containment applications-virtually Total Design Fle�libility. anywhere that water needs to be contained. DuraTech Pool Gutters feature seamless non- A significant benefit of the RenoSys PVC Pool metallic or stainless steel construction in an Shell is the creative flexibility it affords pool integral pool gutter. Designed to be used designers. Because it easily spans cracks and specifically m the public pool market, DuraTech eliminates leakage at cold joints,RenoSys can be P y P P used to make completely watertight any pool can be employed either with or without the ti r• rtmodification including zero depth pool conversions. RenoSys membrane liner.When combined with a " 'S!'•`' The RenoSys sales team will be happy to suggest „`; RenoSys liner and a concrete or stainless steel specific solutions to your design issues and show how the RenoSys material can be employed to allow wall, a DuraTech gutter is a cost effective __' alternative construction techniques. method of constructing a new commercial pool. Hot air thermal fushion welding bonds the liner. Compression flanges secure it at penetrations. �$ 'tJ J..j1 �j.`+.J,-�'CJ,.^..r1a`}•.�,�Ni �S '3 � ["f ` tom. a` �Pfir(, arta 1 r ii' r gs�'r7Z T r `�"� < a,T , k5rtizC srzh34 �„ `h 4 '4 fir x S"v'gM <'xi` C'V" 6`•y�•mv...S rS s �s,1' it�S L��yiy, 1lse.r�t Li t S £s �ts� r S' L �ets+ys' c G x dk•.;, 'eseTn 7se?.i1surs y>s 1S r7< j^^ rlts rl;`*Ji•J st,+rrl;'i<nrJ; >s l� r.1 5 i.l� ,.L ,.t .. •"..•^;�. -+.cJ lay- � �rt< Y aSr ri<,+-frt< n ✓arta r< •rr+<rarl A TYPICAL CUTAWAY VIEW OFA RenoSys OR DuraTech14 ;� �� x INSTALLATION 0 A DuraTech Stainless Steel or PVC integral pool gutter is leveled and anchored in grout on top of the new or existing pool wall creating an integral pool supply/return system. Q The RenoSys liner can 6e bolted directly to 0 © — the bottom of the DuraTech gutter. RenoSys completely lines the interior of the pool. .(Note: Several termination detail options are . t� available.) Q RenoSys is adhered over a 150 mil geotextile 'L i � e slipsheet which is adhered to the pool surface. ' All penetrations(e.g.at lights,main drains a, etc.)are securely flanged with a plastic' compression plate and are mechanically secured to the pool shell. { Q. Pool deck areas are made watertight, attractive and slip resistant after the installation of a RecDeck flooring system. -- — -- -- --- Finishes New Ones Ri ht From The Start. Build new pools Right Froin the Start. Even When Elevated. The technology and design flexibility provided by the RenoSys system can be RenoSys colorful prints offer an attractive employed to affordably build new pools and make them absolutely watertight. Marble,Pebble Rock or Mosaic Tile look to the pool RenoSys successfully replaces tile,plaster or paint in new pool construction. to enhance the appearance. Marble is shown below, A RenoSys liner,when combined with the DuraTech Pool Gutter and a stainless Mosaic Tile is shown an the back page. steel structural wall system,can result in a much longer lasting,more affordable commercial pool. I RenoSys shown in an elevated new pool application with RecDeck flooring. �T _ The Permanent pool Within A pool conceyt. Unique Solutions The RenoSys PVC Pool Shell specific application.All Pr y� is a proven system of pool RenoSys membranes come to Pool P I o b 1 e 11l S construction and renovation with a factory applied anti- components that are custom soiling acrylic top coating. y — --L tailored on site to create an Since RenoSys membranes are .,a attractive pool interior shell acrylic top coated and pore inside a new or existing free,they are designed to be • it ' ,-, �+�� `� structure.The final product is easy to clean and maintain. monolithic,guaranteed The entire system is installed � N h watertight,easy to maintain employing hot air thermal C+ r and with proper care,should fusion welding to make the q last in excess of fifteen to seams stronger than the twenty years. material itself.The RenoSys RenoSys PVC Pool Shells are membrane is generally fully built from a tough,60 mil thick adhered to all pool walls and • PVC membrane installed over a floor perimeters and is 150 mil thick polyethylene felt securely attached with a pad slip sheet.The membrane watertight compression strip. is manufactured to exacting The system is not dependent standards from state of the art for its performance success on t-- 0 virgin PVC compounds,anti- a full structural bond with the "V. fungal agents,and an inner pool floor and walls and it is core of non wicking fiber therefore unaffected by pool reinforcement.The surface structural movement in may be either smooth or earthquake zones or due to II textured depending upon the extreme freezelthaw conditions. �a cti' I - M' I r Focused on Aquatics. PVC Pool Shells,PVC Grating and Bullnose Systems, PVC Leisure Flooring,PVC and Stainless Steel Gutters,Pool Safety Padding, ___ — — Main Drain Boxes...the list of quality products from RenoSys continues to grow. We would be honored to add you to our customer list. xenosys warranty, and Technical Data. Renosys Deslgn palette RenoSys complies with all applicable local, state and national codes. Rall Size 6' x 82.5' x 60 mil thick. O O Material Is manufactured employing polyester reinforcing for maximum puncture resistance, soil guard acrylic top coating, anti-fungal agents and is formulated specifically for the pool environment. Three textures are available. Request bid specifications, product usage guidelines, Light Carribean White Pebble Marble 1" Mosaic ASTM test data and construction details. Full AIE design Blue Blue Rock Tile assistance is available on diskette, online or on CD Rom. The RenoSys PVC Pool Shell is warranted for a full Ten Years from date of installation. (see warranty for details.) YOU Local Dealer: RenoSys Corporation 2825 East 55th Place Indianapolis, IN 46220 (800) 783.7005 (317) 251.0207 Fax (317) 251.0360 email: "renosys@aol.com" Copyright 1990—2002 RenoSys Corporation Visit our website: "www.renosys.comn i K17 47 111ku• I� i �� .`p'y�£��4M_,y� -1 v,.'{^l�rc�� } ,4 S 'p`ij� �.'a! 6l ,.{g.§:'.tr��"x t�_++tiw^'k�.,,�,w '1 yar>'zk"a•gn'..�'yryt'�t. �.ty l$ty��: � � � �i¢S `1a- Y f'° t".,e•,y,x «y}wVp} •yi+ s, ^S j F �R+,.fo'w, xg' r, :..j�36.�R �y�� I'M ;��ISO RkSr�^��?"yY +�'JiPt��'�Y'i�, it�.�+.VP 1-�„ Y. Y y`'ry�� "S• �p�M + i•y„ Y u �s'S 'Lk IMA 4 ,�q.6im-fits rpt''"q '.�y� Ys � .i�• -.�`�. --"=° ? �f ]F'�' � _ }� ^'�e� �a-•`h,. $ya �7��s#�.. } C �r� a ¢«s'��a _� Kfy-u N h x4 � � `54p` «,. a: Ir WE <?a_ '`,e ,� `Sz ,y,*T a '"rrt�i4a�,(�, m 'Sti..xka r.' p �s- a Via" }a4..w� iyxuge sJ ¢5�G'Sf. a i��J�yG ✓,tvp5"�. F-` � �'ttfiif+x4`�+•-Y 'TF gY�F��y G'°� �dlT1q B'S£YD'f,E+w! ,�t;y�p3k✓. e� iY .fT. '�L� � .. fit1 1 OVA teh lope 01 At gqw f I /�� a \ +S err' 1 q M 7 `��r �( '"• ' ""�^✓ 1 � J � tt t �F\�i;'!� .�'i- %�,t �,\ 5f��'T �n '*n �t S f jFSJ�I y {��1-1 F'(°v�4Tj 1 I � � lF" J ��4 y •�4 'rt f 1� v E�fiC• ff All ppTN" ! g f _ X25 5.. � �T+. _� t ��.{ 1,•`} _�tljt +h yr L J fia"� ti'r .✓ 'F y6� -•�f Or 1 Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor " SALEM,MA 01970 DATE PRINTED: 05/20/2008 ESTABLISHMENT NAME: Princeton Crossing Pool File Number:BHF-2004-000195 12 Heritage Drive Salem MA 01970 LOCATED AT: 0012 HERITAGE DRIVE SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2008-0462 May 20,2008 Dec 31,2008 $140.00 DATES OF OPERATION: SEASONAL Memorial Day -Labor Day HOURS OF OPERATION:Mon-Frid I lam to 7pm Sat&Sun loam to 6pm/ SEMI-PUBLIC Total Fees: $140.00 PERMIT EXPIRES IDecember3l, 2008 Board of Health r! _ Page 1 May 12 08 01138p Joanne Scott Salem BOH 978 745 17343 v p. 2 t QTY OF SALEM, MASSAQ iUSEM 1z � ` BOARD OF HEALTH <. 726V7A5t1t3U')'ON$TktttET,4T"Flttcx{ TEL.(978)741-186u KIMBERLEY DRISOOLL FAx(978)745-0343 MAYOR 18572Tt"rjA EM,COM JOANNESO.-M, FIEnt.TH ACENt - 2008 APPLICATION FOR PERMIT lTO OPERATE A SWIMMING POOL LOCA"1TON Or i'OOIYA/ NAME OF APPILICANT4�klet z ��_TFL# G—i�LcJG� MAILINGAT)DRESS CERTI ED PC�SJL OP�f2ATOR Nan,c � . .- _Cert# _TLL N. rr : DATES OP OPERATION (ifn<x annual)_ L� 1 � '42f. DAYS &HOURS ON OPPRATION: TYPE OF POOI. Public _ Scmi-Public ,/_ Special Purpose _ FEE: $210.00 for year round po I: $140.00 for casonai$40.00 Non-Profit (Please pity total with one check p e City of Salon) This permit is not transferable and must be reissued upon change of ownership, In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all pians for such most be submitted to and approved by the Salem hoard of Health. Pursuant to MGL Chapter 63C:, Section 49a, t certify under the pains and penalties of perjury that I,to my best knowledge and belief,nave filed l 'to tax recut nn andpaidall stale taxes rewired under the law, p Signature / Date SS4 or9'edural ldentilication Number Rc,i ed 8114107 pw41j)p.wpd (:hack tt Date � �b FROM FAX NO. Mar. 17 eeb» e1:ebrll rl 4775 Granby Circle Colorado Springs,CO 80919-3131 719.540.9119 • 719.540.2787 (FAX) • www.nspLorg A. nnn.•proflu foundation encouraging healtbier living through aquazic education and research Congratulations on completing the requirements for becoming a Certified Pool-Spa Operator°"}? Your CPO certification is valid for a period of eve a rs from the date of certification. At that time, you will be required to successfully complete another CPO certification class in order to maintain active status, As a graduate of the CPOO) certification program,you will be performing a public service by operating a safe, clean, efficient, and economical aquatic facility. The National Swimming Pool Foundation has confidence that you will do an excellent job in performing your duties. Please remember that complaints from health officials, resulting in disciplinary or administrative action taken against you, may result in suspension or loss of CPe certification. 1n order for us to maintain our communications link with you,please inform us as soon as possible of any change in your address,telephone, or e-mail address. You may contact us at: :National Swimming Pool Foundation 4775 Granby Circle Colorado Springs, CO 80919-3131 719.540.9119 (Telephone) 719.540.2787 (FAX) epoprogram@nspf.org (B-Mail) Don't forget to check out the NPSF*web site (www.nsaf org)on a regular basis for up- to-date information on educational products and industry news, Good luck on a bright and sparkling future! Please do not hesitate to let us know if we may be of assistance to you in any way. Sincerely, W CcrtiGcd V.W I:W l NVa1i11W. •�l✓lklNllllW 'Phomas M. i..achocki, Ph.D. d,r. Chief Executive Officer cntrMam pbaw,Na. G7�200fi5,� � ,uti�dyru,inworappy:mrod NAnoNAL swimmmG P[nov.-YmINVIVAION on 132/Ofi MIUMD Y. INSTAOOIYA ,P,. n� (:.Y..if. �..L4 �+9MMae� Inspection of c+C.il tJ roysc-,'(n Cid. Date F51) -�f U �' Time jn �P11 � p Name 114t-- Address / ) Owner Tel, No. � n Type of Inspection...J A 11IY a _ Inspector.. (A ( ' 1 Remarks and Violations are listed below:: V 4 el G,( in02/12 OJQ S l''61 )d Oc4 -( Im"i y4Q_ '//�u>//7G/ wPIce lD✓DyICL Sr�cs011'' �r 11C1P, .PirioF nP� /T1hS'lC' nYOU / D u e G 1`2iq Ce 1a) " fl I rlr�� (/ r Report Received by: ,—. y Inspection.,: (nwin1 t .o)5g(nq Date ! 2-1)1l Time 6A /�� Name i Address _�"�/ N-r✓li�� />/�[r�-K.. !` Owner (( Tel. No. f. N.\ Type of Inspection _.,a A I I IX r t-`Y' \ Inspector,. I A ( ' ) Remarks,and Violations are listed/below:, V '6t00041-( /01 /w ;;,11(,1,0. 'iCtIMilgIC 4 GP K0 • -- ;'_. Report Received by:(,— � r Inspection of khC'P..V"h1 Ci 0S<,rr IPC Date 9//61/09/09 y Time Name Address -rlata' 11(. v – Owner / U Tel. No. ` • _` �{{� Type of Inspection VooI Inspector��R101kd, gQ SDi0ane ( � 1 Remarks and Violations are listed below: ooDI ;nsecfon ( �� Con�uc��<7 an�l 'TC�e �blltl-�In� I v — �4 17 GiISS 0(5 v _ _ - Cc kz;� GP'Q V�7 -z4e v.P � 'Irr,►� �� 1'�Psket e-(-s cj�e�� l OL�cicx YYlcrcle c�,�r �l rx h/� (n wca7; `7, 6 and :ip—p ! 1 C r L In 4< Sklrv—� a- I`C�Yl�lnc �Nj, tixr`r/ I,,.(- /s -,P( we") . Sanlifian Report Received by: _f y Tim{-eInsPect!on oDate . Name `� Address i IGrn Owner f Tel. No. / Type of Inspection Poo I Inspector. �C+�i(�i "c. / ��IO!)O ( � 1 Remarks and Violations are listed below: ►�ti' - �lil ��, (� l �I)- J)eCh ')r) Cor)(�u(c,f ajiC/ 11,P- ' id til•, lac{� ��{� CA v _ `;PC ✓(mac I TJ �C'C . tx f� >t�N �S h �tllt� ��z,rr�lr�ils — ilt ��i � x C4-,fl',t 10u,. (S RtP,. tli /, l? xiid 4 ,r —111 :w - 1t .(( J 4 11dr,V V C- 'n t{ 1 I1,C I" 1 c ,-)f 1 n l - ,! f f ir. , f5 t^ it�;.�t� tit Ur't . l . 4 SO111` aflctrl ( t �t tl!lf: t tak l ltd 1. Report Received by: 'Qw 3Yi! " y CITY OFa5ALEM'$OARDtOF HEALTH X120=WASHINGTON,STREET,�,4TH:FL00R,mSALEM,' MA,0197.0 ; 1-1 d. r•HI'w w.w«s ..aw. Yom. ON— pool SS Date: cJ j Q Address: Phone: Operator: Max. bathutg load:_ In accordance with 105 CMR 435-000 Minimum Standards jor Swimming Pools,- State Sanitary Code: Chapter V c .—wid UAL PERMIT POSTED cbu m, {2v2�s 5�ta HALTH and SHOWERSIGNS POSTED HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no / glass. _V- LIFEGUARDS: Present �- h q ftfC bucr td P'(644 _ - certification - red/orange suit J_ - "guard" printed on jersey _ - sunblock avail. v -voice amplifier — -elevated seat EMER- COICATION: phone at pool yphone instructions emergency numbers phone in unlocked area _ - SAFETY EQUIP.- for each 2040 sq- feet p rescue tube or ling buoy (with rope) S W� N 'jA - backboard with collar and straps 5 - FIttS i �i� :�cuipment a:ea C.� _ (35) 1" bandaids t �10) 30 gauze -(2) 5"x 9" suigipads -(1) 5x10 surge2) 2" soli roller bandages - scissors 2) 3" soft roller bandages tweezers (1} 112" roll of hyperallergenic tape _✓rescue blanket �ce packs I2) antiseptic wipes / — - pocket mask — -(1) sterile isotonic eye wash - DISINFECTION r2 0.6 - cli3oriue p13 7.2 - 7.8 residual free 1-3, combined 0-0 2 bromine pl1 T2 - 7.8 Residual: 2-6 (ppm) (Mq/i) 1 ! pt water tests /chemicals used V_ - backwaslimn , b� attendance hours of operation 11/oFf'TII MARKINGS: sidewalk and inside pool DIVING 130Al2DS: rigidly consuzlcted, properly anchored, braced lou heavies( to+ld, no splinters car cr;lcks, nor ;hp ;ia fate not ovcl 10' above water k:vc,t and a;1Cx;t i ) rutobstnlcted headroom BA I HIMSL- Selxt3tc 01cssmr-311d Sannary tlQlltics roe each sea .adjaeenl to poo(, wpll-hrhicc dlamcd, �"YY JJ vntbta[ed, untxrvaous eonstnaeoon,one shower mad one toiler(xi do bao,us, hot and cold wain-soap piovidcd no 't✓( coni most cups, towels_comhs extol adcQuaicly r,ndo5cd appro�,rA dnnkin}', watcl rac,litics received by — inspectcd by MATERIAL SAFETY DATA SHEET MSDS Number: 53010CWD 1. PRODUCT AND COMPANY IDENTIFICATION Product Name: OZIUM GLYCOL-IZED AIR SANITIZER -ALL SIZES & FRAGRANCES (continuous spray type) - EPA REGISTRATION # 51838-02- 9444 Manufactured for: Waterbury Companies, Inc. P.O. Box 640RECEIVED Independence, LA 70443 24-Hour Emergency Contact: MAY 2 72008 800-424-9300 (CHEMTREC) CITY OF SALEM 2. COMPOSITION/INFORMATION ON INGREDIENTS BOARD OF HEALTH Hazardous components greater than 1.0% (0.1% if carcinogen or suspected carcinogen,) Com onent JCAS# JOSHA PEL JACGIH TLV Other Limits % by wt Isopropanol 67-63-0 400 ppm 400 ppm 500 ppm 45-55 ACGIH STEL n-Butane 106-97-8 N.E. 800 ppm 800 ppm TWA 5-15 Non-hazardous components N/A N/A N/A N/A 5-15 Perfume Oils-Supplier Trade N/A N.E. N.E. N.E. <5 Secret Propane 74-98-6 1000 ppm N.E. 1000,ppm 15-25 TWA Triethylene Glycol 112-27-6 N.E. N.E. N.E. <5 This item is NOT a carcinogen, but has been listed to aid in the identification of all pesticide active ingredients in the product. Actual percentages for these active ingredients have been listed vs. percent ranges. 3. HAZARDS IDENTIFICATION 0 Warning! Flammable! Contents under pressure, do not expose to fire or extreme heat. It is a violation of federal law to use this product in a manner inconsistent with its labeling. Read label. Do not spray on painted or lacquered surfaces. Potential Health Effects: Routes of Entry: Inhalation: Yes Ingestion: Yes Skin: Yes Health Hazards: Overexposure to Isopropanol (or its components) has apparently been found to cause the following effects in laboratory animals: Liver abnormalities, kidney damage, and central nervous system effects. Dermatitis. Signs/symptoms Central nervous system effects of isopropanol (or its components) includes of overexposure: dizziness, weakness, fatigue, nausea, and headache. Nasal and respiratory irritation, mild skin irritation, defatting, dermatitis, eye irritation. If swallowed - gastrointestinal irritation, nausea, vomiting, and diarrhea. Medical conditions Persons with pre-existing skin disorders, eye problems or aggravated by exposure: impaired respiratory function may be more susceptible to the Revision Date: 3/19/01 Date Printed: 3/21/01 Page of 4 MATERIAL SAFETY DATA SHEET MSDS Number: 53010CWD effects of this substance. NFPA Hazard Ratings Fire: 4 Health 1 Reactivity: 0 NFPA 704 Ratings are subject to interpretation and are only intended for general identification of the level of the specific hazard. All information must be considered for proper safe handling of the material. 4. FIRST AID MEASURES IF IN EYES: Irrigate with plenty of water for 15 minutes. IF ON SKIN OR CLOTHING: Remove contaminated clothing and wash with soap and water before reuse. Wash affected areas with soap and water for 15 minutes. IF INHALED: Remove to fresh air. IF SWALLOWED: Call a physician or Poison Control Center. Do not induce vomiting. Seek medical attention if irritation persists. 5. FIREFIGHTING MEASURES Extinguishing Media: CO2, dry chemical, or foam Fire Fighting Procedures: Self contained air supply suggested. Keep containers cool to avoid bursting. Unusual Fire and Explosion Hazards: Exposure to temperatures above 130 deg.F may cause bursting. 6. ACCIDENTAL RELEASE MEASURES If container is ruptured or begins to leak, place in a well-ventilated area free of spark and ignition sources. Any remaining liquid should be collected with absorbent media. Dispose of unusable concentrate and absorbent media in accordance with Local, State and Federal regulations. 7. HANDLING AND STORAGE Spray for one second towards center of room, away from drapes, walls, etc. to reduce airborne bacteria in an average size room (10' x 14' x 8'). Repeat application several times daily. For smoke and odor control, treat average size rooms twice with one second sprays. Store in a cool dry area away from heat or open flame. Exposure to temperatures above 130 deg.F. may cause bursting. NFPA 308 Aerosol Classification: Level 3 Aerosol 8. EXPOSURE CONTROLS/PERSONAL PROTECTION Protective Gloves: Disposable where repeated and prolonged skin contact is expected to occur. Eye Protection: Not required - avoid contact with eyes. Respiratory Protection: Not required. Use in well-ventilated area. Ventilation: Local: Not required. Under normal conditions, room ventilation is generally adequate. Mechanical: Explosion proof where excessive amounts of material are released (i.e.): If cases of product are crushed. Otherprotective equipment: None applicable. Protective Work/Hygiene Practices: To prevent accidental spraying keep protective cap in pla Revision Date: 3/19/01 Date Printed: 3/21/01 Page 2 of 4 MATERIAL SAFETY DATA SHEET MSDS Number: 53010CWD 9. PHYSICAL AND CHEMICAL PROPERTIES Specific Gravity(H20=1): 0.8 Vapor Pressure (mm Hg): 5,171 Solubility: Essentially complete Appearance/Odor: Golden to yellow aerosol spray. Perfumed and distinct odor. Flashpoint: Flammable per flame projection test. LEL: N/A UEL: N/A Boiling Point: N/A Melting Point. N/A 10. STABILITY AND REACTIVITY Conditions to Avoid. Excessive storage temperatures. Incompatible Materials: Strong acids such as sulfuric, hydrochloric, nitric or other chemically de-hydrating compounds. Hazardous Decomposition By-products By-products of incomplete combustion may include carbon monoxide, carbon dioxide, and other unidentified organic vapors and mists. Hazardous Polymerization Conditions: None known. 11. TOXICOLOGICAL INFORMATION This product contains no chemicals that are listed on the NTP, IARC, or OSHA carcinogen lists. Any further information on the toxicology of the material can be obtained by contacting the manufacturer. 12. ECOLOGICAL INFORMATION Please call the manufacturer for questions concerning the ecological effects of this product and it's constituents. 13. DISPOSAL CONSIDERATIONS Do not reuse empty container. This container may be recycled in the few but growing number of communities where (steel) aerosol can recycling is available. Before offering for recycling, empty the can by using the product according to the label. (DO NOT PUNCTURE!) If recycling is not available, wrap the container and discard in the trash. Any remaining or collected liquid from punctured cans should be disposed of in a safe manner at an approved facility in accordance with Local, State, and Federal regulations. 14. TRANSPORT INFORMATION Status Shipping Name Class ID# Pkna Grp DOT(USA): Regulated Consumer Commodity (per ORM-D N/A N/A 49CFR173.306) IATA (Air): Regulated Consumer Commodity 9 ID8000 N/A IMDG (Vessel): Regulated Aerosols 2 UN1950 N/A National Motor Freight Classification and LTL Class: 57100 Sub 3 Class 60 15. REGULATORY INFORMATION Revision Date: 3/19/01 Date Printed: 3/21/01 Page 3 of 4 MATERIAL SAFETY DATA SHEET MSDS Number: 53010CWD SARA Title III Section 31 When completing Tier II reports, the following information should be used Note: See state and local regulations for specifics on reporting requirements for your facility. This product should be described as: PURE: N MIXTURE Y SOLID: N LIQUID:Y GAS: Y Physical Hazards: FIRE:Y PRESSURE: Y REACTIVITY: N Health Hazards: IMMEDIATE: Y DELAYED: N SARA Title III Section 313: Toxic chemical components subject to the reporting requirements of EPCRA and 40CFR372: Chemical CAS/Category Percent Glycol Ethers N230 4.40 16. OTHER INFORMATION Product_Sales Information: 800-845-3495 MSDS Information: 985-878-6751 Revision Notes: MSDS revised to comply with ANSI Z400.1-1998 16-Section MSDS format. N/A = Not Applicable N.E. = Not Established MSDS Prepared by K.G. This Information is provided in good faith, but no warranty, expressed or implied, is made. The manufacturer believes that it is accurate and to the best of its knowledge, and relates only to the specific material designated herein. Revision Date: 3/19/01 Date Printed: 3/21/01 Page 4 of 4 'S6 =y3 I MATERIAL SAFETY DATA SHEET GLB Super Charge 1. Product And Company Identification Supplier Manufacturer GLB Advantis Technologies, Inc. 1400 Bluegrass Lakes Parkway 1400 Bluegrass Lakes Parkway Alpharetta, GA 30004 United States Alpharetta, GA 30004 United Slates Telephone Number: (770)521-5999 Telephone Number: (770)521-5999 FAX Number: (770)521-5959 FAX Number: (770)521-5959 Web Site: www.poo)spacare.com Web Slte: www.poolspacace.corn Supplier Emeraency Contacts& Phone Number Manufacturer Emergency Contacts&Phone Number CHEMTREC- DAY OR NIGHT: (800)424.9300 CHEMTREC-DAY OR NIGHT: (800)424-9300 Issue Date: 02116/2006 Product Name: GLB Super Charge Chemical Name: Calcium Hypochlorite CAS Number: Not Established Chemical Family: Oxidizer _ Chemical Formula: Proprietary MSDS Number: 99 2. Com osition/information On Ingredients Ingredient CAS Percent Or Name NumberQu, ht CALCIUM CARBONATE 471-34.1 CALCIUMCHLORATE 10137-74.3 CALCIUMCHLORIDE Not Establish CALCIUMCHLORIDE 10043-524 CALCIUM HYDROXIDE - CALCIUMHYPOCHLORITE 7778-54-31 1 SODIUMCHLORIDE 7647-14-51 1 Ingredients listed in this section have been determined to be hazardous as defined in 29CFR 1910.1200. Materials determined to be health hazards are listed if they comprise 1%or more of the composition: Materials identified as carcinogens are listed if they comprise 0.1%or more of the composition. Information on proprietary materials is available in 29CFR 1910.1200(i)(1). Hazards Identification (Pictograms) 3. Hazards Identification Primary Routests) Of Entry Skin Contact, Eye Contact, Ingestion Eye Hazards Causes severe eye burns. Page 1 of 6 ,I MATERIAL SAFETY DATA SHEET GLB Super Charge 3. Hazards Identification-Continued Skin Hazards Causes skin irritation, Inuestion Hazards If ingested,get immediate medical attention. Inhalation Hazards Causes respiratory tract irritation. May cause severe allergic respiratory reaction. Chronio/Carcme eni�Effects Chronic exposure may cause impairment of lung function or lung damage secondary tissue destruction Signs And Symptoms - Inhalation of dust or vapor from this product can be irritating to the nose,mouth, throat and lungs. In confined areas, mechanical adglation can result in high levels of dust,and reaction with incompatabie materials can result in high concentrations of chlorine vapor either of which may result in burns,wheezing, choking,chest pains,impairment of lung function and possible lung damage. Severe eye irritation and/or bums can occur following eye exposure. Contact may cause impartment of vision and corneal damage. Dermal exposure can cause severe irritation and/or burns characterized by redness,swelling and scab formation, Prolonged exposure may cause permanent damage. Conditions Aggravated By ExooAure. Asthma, respiratory, and cardiovascular disease May be fatal if swallowed. Avoid breathing dust or fumes. Harmful 0 product is inhaled In high concentrations. Causes skin, eye digestive tract and respiatory burns. First Aid(Pictograms} r 4. First Aid Measures In case of contact, hold eyelids apart and Immediately flush eyes with plenty of water for at least 15 rninutes_Call a physician or a poison control center immediately. Skin In case of contact,immediately flush skin with plenty of water for at least 15 minutes. Call a physician or poison control center immediately. Remove contaminated clothing and shoes. Thoroughly clean shoes before reuse.Wash clothing before reuse. Ingestion DO NOT INDUCE VOMITING. If victim is fully conscious,drink large amounts of water.Cal a physician or a poison control center immediately. Inhalation If inhaled, remove to Iresh air.Call a physician or a poison control center immediately. i Page 2 or B E MATERIAL SAFETY DATA SHEET GLB Super Charge Fire Fighting (Pictograms) 5. Fire Fighting Measures Flash Point: NIA°.F Fire And Explosion Hazards This product is chemically reactive with many substances. Any contamination of this product with other substances by spill or otherwise may result in a chemical reaction and fire. This product is a strong oxidizer which is capable of intensifying a fire once started. Extinguishing Media WATER ONLY. In case of fire, soak (flood)with water. DO NOT USE Dry Chemical OR OTHER EXTINGUISHERS CONTAINING AMMONIUM COMPOUNDS Fire Fighting Instructions Firefighters should wear self-contained breathing apparatus and full protective gear. GRINDING OR INTENSIVE MIXING MAY GENERATE SUFFICIENT HEAT TO FUSE PRODUCT AND CAUSE IGNITION OF OXIDIZABLE MATERIAL PRESENT. 6. Accidental Release Measures Clean up spill immediately. Flush spill area with water in compliance with State and Federal Regulations. Handling &Storage (Pictogramsl 7. Handling And Storage Handling And Storage Precautions Keep out of reach of children. Store material in a cool and dry'place. Handling Precautions Avoid breathing dust or vapor. Avoid contact with skin and clothing.Avoid contact with eyes. Storage Precautions Keep product lightly sealed in original containers. Store In a cool dry place. Store in a dry,well ventilated place. Keep away from combustible or flammable products. Keep packaging clean and free from contamination including other pool treatment products , acids,organic materials, nitrogen containing compounds, dry powder fire extinguisher(containing mono-ammonium phosphate),oxidizers,all corrosive liquids,flammable or combustible materials Do not store at temperatures above 52C (125F)Storage above this temperature may result in rapid decomposition, evolution or chlorine gas and heat sufficient to ignite combustible materials. Work/Hygienic Practices Use safe chemical handling procedures suitable for the hazards presended by this material. Page 3 of 6 MATERIAL SAFETY DATA SHEET GLB Super Charge Protective Clothing (Pictograms) 0013 ® 8. Exposure Controls/Personal Protection Enoineerino Controls Use with adequate general and local exhaust ventilation. Wear NIOSH approved respirator if dusts are created. Eye/Face Protection Safety glasses with side shields or goggles recommended. Skin Protection Chemical-resistant gloves, impervious,sult may be required. Respiratory Protection Use NIOSH/MSHA approved dust and mist respirator when applicable. Ingredients) -Exposure Limita CALCIUM CARBONATE OSHA (PEL) ACGIH(TLV) TWA 15 mg/cubic-meter(total dust) 10 mg/cubic-meter 5 mglcubic-meter(respirable fraction) CALCIUM HYDROXIDE ACGIH(TLV)5 mg/cubic-meter CALCIUM HYPOCHLORITE 3 mglcubic meter(celling)as chlorine manifactures internal exposure limit 9. Physical And Chemical Properties Appearance While granules or powder Odor Chlorine Chemical Type: Mixture Physical State: Solid . Melting Point: DECOMPOSES °F Boiling Point DECOMPOSES°F Specific Gravity: n/a Molecular Weight: 143(Active) Percent Voliiales: n/a Packing Density: 0.8g/cc Vapor Pressure: n/a pH Factor: 10.4-10.8 At a Concentration Of 1% solution Solubility: 18% @ 250 Corrosive, Oxidizer 10. Stability And Reactivit Stability: See comments Hazardous Polymerization: Will not occur Conditions To Avoid (Stability) ' This product may be unstable at tempratures above 170C (338F) Page 4 of 6 MATERIAL SAFETY DATA SHEET GLB Super Charge 10, Stability And Reactivity -Continued Incompatible Materials Keep packaging clean and free from contamination including other pool treatment products , acids,organic materials, nitrogen containing compounds, dry powder fire extinguisher(containing mono-ammonium phosphate), oxidizers, all corrosive liquids, flammable or combustible materials Hazardous Decomposition Products Chlorine Gas ' Conditions To Avoid(Polymerization) Avoid temperatures above 125 F (52C) Prevent ingress of humidity and moisture into container. Always close the lid. 11. Toxicological Information Eye Effects Severe irritation and/or burns can occur following eye exposure. Contact may cause impairment of vision and corneal damage. Skin Effects Acute dermal exposure can cause severe irritation and/or bums characterized by redness, swelling and scab formation. Prolonged skin exposure may cause permanent damage. Chronic effect of skin exposure would be similar to those from single exposure for effects secondary to tissue destruction. Acute Oral Effects Irritation and/or burns to the entire gastrointestinal tract, including the stomach and intestines,characterized by nausea,vomiting, diarrhea, abdominal pain, bleeding and/or tissue ulceration. Due to the corrosive nature of this product ingestion may be fatal. Acute Inhalation Effects Inhalation of dust or vapor from this product can be irritating to the nose mouth , throat and lungs. In confined areas mechanical agitation can result in high levels of dust and reaction with incompatible materials can result in high concentrations of chlorine vapor,either of which may result in shortness of breath,wheezing,choking,chest pains, - impairment of lung function and possible lung damage. Conditions Mgirwated By Exposure Asthma, respiratory and cardiovascular disease. 12. Ecological Information Toxicity-Aquatic And Terrestrial Plants Bluegill, 96 hr. LC50 0.088 mg/I (nominal, static) Rainbow trout, 96 hr. LC50: 0.16 mg/I (nominal, static) Daphnia magna,48hr. LC50: 0.11 mg/I(nominal, static) Acute And Dietary Toxicity -Birds Bobwhite quail, dietary LC50:>5,000 ppm Mallard ducklings, dietary LC50:>5,000 ppm Bobwhite quail oral LD50:3474 mg/kg 13. Disposal Considerations This product meets the criteria of a hazardous waste as defined under 40 CFR 261. It is subject to Land Disposal restriction under 40 CFR 268 andmustbe managed accordingly. Dispose in accordance with applicable federal, state and local government regulations. Page 5 of 6 MATERIAL SAFETY DATA SHEET GLB Super Charge 14. Transport Information ProoerShiooing Name RQ CALCIUM HYPOCHLORITE, HYDRATED MIXTURES Hazard Class 5.1,13GII (<1 KG Consumer Commodity ORM-D) DOT Identification Number UN2880 15. Regulatory Information U.S. Regulatory Information This material is regulated as a DOT hazardous material. It is also regulated by FIFRA, USDA, and FDA. This substance is listed on TSCA. NSF Maximum Drinking Water Use Concentration 46mg/I as Calcium hypochlorite SARA Hazard Classes Acute Health Hazard Fire Hazard Reactivity Hazard NFPA HMIS 3 0 th t OX REACTIVITY ❑1 PERSONAL PROTECTION �E 16. Other Information Revision/Preparer Information MSDS Preparer: JHW3 This MSDS Superceeds A Previous MSDS Dated: 0911812000 Disclaimer Although reasonable care has been taken in the preparation of thisdocument, we extend no warranties and make no representations as to the accuracy or completeness of the Information contained therein, and assume no responsibility regarding the suitability of this Information for the user's Intended purposes or for the consequences of its use. Each individual should make a determination as to the suitability of the information for their particular purposes(s). GLB vrm'ee mmo Ms:S Gmunwr'•zcoa Page 6 of 6 --- S.3 3 S 7 ATERIAL SAFETY DATA SHEET &, n,h.a.rbj, Robarb 3" Tablets 1. Product And Company Identification Suaotier Manufacturer Robarb Advantis Technologies, Inc. 1400 Bluegrass Lakes Parkway 1400 Bluegrass Lakes Parkway Alpharetta, GA 30004 United States Alpharetta, GA 30004 United States Telephone Number: (770)521-5999 Telephone Number: (770)521-5999 FAX Number: (770)521-5959 FAX Number. (770)521-5959 Web Site: www,poolspacare.com Web Site: www.poolspacare.com Suoolier Emeraency Contacts&Phone Number Manufacturer Emergency Contacts& Phone Number CHEMTREC -DAY OR NIGHT: (800)424-9300 CHEMTREC -DAY OR NIGHT: (800)424-9300 Issue Date: 02/28/2006 Product Name: Robarb 3"Tablets Chemical Name: Trichloro-s-Triazine-Trione CAS Number: Not Established Chemical Family: Chlorinated Isocyanurates Chemical Formula: C3N303C13 MSDS Number: 52 2. Composition/information On Ingredients Ingredient CASPercent of Name Number Total Wel ht T,[oWro-s.Triazme-Triona 87-00.1 Ingredients listed in this section have been determined to be hazardous as defined in 29CFR 1910.1200. Materials determined to be health hazards are listed if they comprise 1%or more of the composition. Materials identified as carcinogens are listed if they comprise 0.1%or more of the composition. Information on proprietary materials is available in 29CFR 1910.1200(1)(1). 3. Hazards Identification Primary Routesis)Of Entry Skin Contact,Inhalallon Eve Hazards Irritant, severe eye. Skin Hazards Causes skin irritation. Ingestion Hazards Causes digestive tract burns. Inhalation Hazard Causes respiratory tract irritation. Signs And Symptoms Irritation of Eyes and Respiratory Passages Page 1 of5 MATERIAL SAFETY DATA SHEET Robarb 3" Tablets 3. Hazards Identification -Continued Conditions Aggravated Bk Exposure Asthma, Resplatory and Cardiovascular Disease First Aid (Pictograms) Q 4. First Aid Measures Eve In case of contact, hold eyelids apart and immediately flush eyes with plenty of water for at least 15 minutes.Get medical attention immediately. Skin In case of contact, immediately flush skin with plenty of water.Get medical attention immediately if irritation (redness, rash,blistering)develops and persists. Ingestion Drink large amounts of water.Avoid Alcohol. Do not induce vomiting:Contact a physician or poison control. Inhalation If inhaled,remove to fresh air. Fire Fighting (Pictograms) 5. Fire Fighting Measures Flash Point: n/a°F Flammability Class: NOT FLAMMABLE Fire And Explosion Hazards SMALL QUANTITIES OF WATER WILL REACT WITH THIS PRODUCT TO FORM HAZARDOUS AMOUNTS OF NITROGEN TRICHLORIDE(VIOLENT EXPLOSIVE) Extinguishing Media In case of fire, soak (flood)with water.CAUTION DO NOT USE DRY CHEMICAL CONTAINING AMMONIA COMPOUNDS Fire Fighting Instructions Firefighters should wear self-contained breathing apparatus and full protective gear. 6. Accidental Release Measures Clean up spill immediately. Complete cleanup on dry basis if possible. Use appropriate personal protecWe equipment (PPE).Use appropriate containers to avoid environmental contamination.Spills greater than 100 pounds constitute a reportable quaniliy by the US EPA Page 2 of 5 MATERIAL SAFETY DATA SHEET Robarb 3" Tablets Handling &Storage (Pictograms} 7. Handling And Storage Handling And Storage Precautions Keep out of reach of children. Store material in a cool and dry place. Do not reuse container Storage Precautions Keep out of reach of children. Store in a cool dry place.Do not Reuse container. Keep away from other types of chlorinating compounds and organic material. KEEP AWAY FROM AMMONIA AND AMMONIA COMPOUNDS. WorklHyoienic Practices Use safe chemical handling procedures suitable for the hazards presended by this material. Protective Clothing 1Pictogramsl 13 CM . 8. Exposure Controls/Personal Protection Engineering Controls Use with adequate general and local exhaust ventilation. EyeiFace Protection Safety glasses with side shields or goggles. Skin Protection Chemical-resistant gloves. Respiratory Protection USBM approved respirator with appropriate canister Wear Long Sleeves 9. Physical And Chemical Properties Appearance White tablet Odor Chlorine Chemical Type: Mixture Physical State: Solid Melting Point: NOT ESTABLISHED°F Boiling Point: Decomposes °F Specific Gravity: n/a Molecular Weight: NOTDETERMINED Percent Volilales: <1% Vapor Pressure: NOT VOLATILE Vapor Density: NOTAPPLICABLE pH Factor: 2-3 Solubility: 1.2G/100G IN WATER AT 25C Evaporation Rate: NOT APPLICABLE Page 3 of 5 MATERIAL SAFETY DATA SHEET Robarb 3" Tablets 10. Stability And Reactivity Stability: STABLE Hazardous Polymerization: WILL NOT OCCUR Conditions To Avoid (Stability) THERMAL DECOMPOSITION MAY PRODUCE CHLORINE AND OTHER TOXIC GASES Incompatible Materials - Reducing agents and Oxidizers, Nitrogen containing compounds, Calcium hypochlorite,Alkalies,Acids, Bases Hazardous Decomposition Products Chlorine gas Conditions To Avoid (Polymerization) Water on product while in container. Humidity ii. Toxlcolo ,cal Information No Data Available.,. 12. Ecological Information No Data Available... 13. Disposal Considerations - Refer to applicable local,state and federal regulations as well as industry standards. 14. Transport Information Proper Shipping Name TRICHLOROISOCYANURIC ACID DRY Hazard Class 5.1,PG II (<=ikg Consumer Commodity ORM-D) DOT Identification Number UN2468 15. Regulatory Information Canadian Regulatory Information Class C - Oxidizing Material Class D, Div 2b- Poisonous or Infectious Material: other toxic effects, NEPA HMIS 3 1 0 REACTIVITY 11 PERSONAL PROTECTION CL 16. Other Information - Revision lPreparer Information MSDS Preparer: JHW This MSDS Superceeds A Previous MSDS Dated: 0712612000 Page 4 of 5 MATERIAL SAFETY DATA SHEET Robarb 3" Tablets Disclaimer Although reasonable care has been taken in the preparation of this document, we extend no warranties and make no representations as to the accuracy or completeness of the Information contained therein, and assume no responsibility regarding the suitablilily of this information for the user's intended purposes or for the consequences of its use. Each individual should make a determination as to the suitability of the information for their particular purposes(s). Robarb NrinM Ulm,MGUS Gm1.1`3M Page 5 of 5