40 LEGGS HILL ROAD POOL INSPECTION 6-9-2022 �'w ► �" " C`i,n ov S,41 .I,,\1, l�1, % 1c.1 I l ;"
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SWIMMING POOL INSPECTION REPORT
NAME: DATE: TIME IN: '
ADDRESS: 4WALNE� 40W-M-E OUT:
CERTIFIED POOL OPERATOR: %
Regulations 105 CMR 435.000 :Mini tun Standards for Swimming Pools,State Sanitary Code, Chapter V
` Regulation CompNance
Number Yes No Title and Description
435.03- Bathhouse: Separate sanitary dressing facilities and water closet for each sex which are well p
"= lighted,drained and ventilated-Showers with hot and cold water-Sanitary drinking water-
g �Y g
toilet paper,soap at sink and in showers(shatter proof containers),paper towels and waste
receptacle
435.06 Water Circulation and Filtration: Over-all recirculation and purification system designed "
recirculates and filters the-entire volume as follows:
• Swimming Pools-Once every eight hours
• Wading Pools-Once every four hours
" { 1 o Special Purpose Pools(Spas)-Once every half hour
Maximum design filtration for filters:
' + High rate sand filter- 15 gpm/W-20.gpm/ft'(NSF filters)
DE filters-2 gpm/W
• Cartridge filters-0.375 gpm/W
Automatic hypochlorimtors required feed-rate capacity:
• Outdoor.Pools-Three pounds of chlorine per 24 hours per 10,000 gallons
I _• Indoor Poole-One pound of chlorine per 24 hour per 15,000 gallons
1 4308 i Ittlets and Outlets-All special purpose and wading pools shall install an emergency shut off
_switch which is accessible, working and prominently marked
14 53 12 Water Depth Markings-Marked on pool deck and on vertical pool wall. Four-inch contrasting
1 \7 color stripe dividing shallow and deeLendsaincluding ledges and steps -
435.21 Permit Requirements and Pool Records Permit posted to conspicuous location, Maintain
fat1 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
L� o `ration of purification etc uipment _
041 435.22 ' _ ~! Ifealth"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
inage 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
P 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
i elderly, pregnant,suffers from heart disease,diabetes,high/low blood pressure-Water
temperature above 104°F-Observe reasonable time linnits-No oils and bad) lotions"
- I asily readable lar_S j al c ock_._.______..__.._._
1
SWIMMJN DQA INSPEC J0N REPQRT
Regulations 105 C1MR 435.000
Minimum Standards Por�wimming Pools,State Sanitary Code,Chapter V
]:NAME:, DA fh:
Regulal on �C m fiance -- -- -
Number es No Title and Description
435.23 i 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 R',One rescue tube and rescue hook Lifeguard
_ I staffed pools shall have readily available a backboard with straps
435.25 First Aid Equipment and Emergency Communication-Provide a standard iced Cross first aid
kit-Working,convenient,immediate, (oil-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 PPM
• pH 7.2-7.8 PPM
Alkalinity 50-150 PPM
Water Testing Equipment-Provide a DPD test kit for measuring chlorine/bromine and
i�
appropriate kit for measuring pH,alkalinity and cyanuric acid-Reagents shall not be more than
one vear old-Provide accurate, unbreakable thermometer for special purpose pools
t i 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 Xards)
' 2 Water Quality Maintenance-Special purpose•- i pools shall be drained,cleaned and refilled a
435.3
- . • minimum of once every 14 days _
' 435.33 Maximum Operating Temperature for Special Purpose Pools-Water temperature not more
_ I than 1040F-Water temperature shall be tested when residual disinfectant and M are tested
1 435.34 Closure of Pool-Operator shall immediately close pool until pawl water conforms to ]OS Clvli
_431.28 thtrou h 435.31 standards _
143538 General Sanitation-All pools,bathhouses and grounds shall be maintained in good repair,safe
I I and sanitary manner.
Remarks,Results and Action Taken:
S �11nnl Wading/Kiddie Pool S,a Ty e: TYPet
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
� t1 lI li
li H
Alki linih• Alkalinity Alkalinity
Alkaliait Alkal•anity�Calcium Calcium Calcium Calcium
Hardness Calcium
Calcium
Hardness Hardness Iardness
a
i,
- - 4
4
. .................. ........... ......... ......... .........
Regubtflons 105 CNIR 435.000
Mininjuni Standards T f Swinnuing Pools,State Sanitary Code.Chapter )i
NAMEJ 11 lul MELD J.W
Remarks, R Its and Aclions-,
Fy)e:
I'Ype:
Free Free Fr ee
Chlorine Chlorine
Cambined Combined Combined
Chlorine Chlorine
Bromine Bromine Bromine
it ail
Alkalinity Alkalinity Alkalinity
Calcium Calcium Calcium
Type: Hardness Hardness Hardness Type:
PC
Pool Pool Pool
V m olue V-
Volume g Volume
Send Sand DE
Filter Type DE Filter Type DE Filter Type
Cartridge
Cartrid,_?e
Cartrid,,,e
Filter Size ft' )QJ Filter Size ftZ Filter Size ft2
Minimum Minimum Minimum
Flow Rate gpin Flow Rate gpm Flow Rate 2pil,
Maximum maximum Maximum
Flow Rate gpaj Flow Rate gpm Flo!!-Rate R m
Actual Actual Actual
Flow Rate�apm_ I'low Rate Om Flow Rate gp
Lim Oxv)f-y-\1\
o ajg4�: 1-7f� ck"Cqni 41
Cyr
Passed Ins pectioK"QNS K 11SPC`t iron Dote.,
Imeeletar's A
Pierson In Charoel* Q'/