SP/Spa Inspection Form

Apr 15, 2016 - Fountain. [ ] Other. Insp Date (mm/dd/yy) 04/13/2016. 2. 8772. 2016081. Travel Time. License no. ID no. Surface Area (sf). Volume (gallons). Required turnover rate. (min) [ie 30]. Required ... Check if in violation of the Ohio Administrative Code 3701-31-04 (A-E); NA= Not Applicable. Insp Time. 20. 20. [ X ].
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Health District:

Public Swimming Pool Inspection Report Name of Facility:

Public Health Datyon-Montgomery County

Type visit

Type pool

Setting

[ X ] Standard

[ X ] Pool

[

] Wading pool

[

] Zero Entry

[

] Spray ground

Special feature (SF)

[

] Re-inspection

[

] SPA

[

] School

[

] Govt

[

] MHP

900 S ALEX ROAD

[

] Complaint

[

] SUP

[ X ] Indoor

[

] Outdoor

[

] Camp

City:

[

] Epi Investigation

[

] Apartment/Condo

[

] Hotel/Motel

WEST CARROLLTON OH 45449

[

] Consulation

[

] Other

WEST CARROLLTON YMCA Address:

Insp Date (mm/dd/yy) 04/13/2016 Surface Area (sf)

[X]

3375

Flow measure reading (gpm)

Insp Time

Travel Time

20

Required turnover rate (min) [ie 30]

ID no.

2

Volume (gallons)

480

135406

300

[X]

[

]

Max allow. flow: SF pump capacity (gpm)

[

] Other

2016081

Required flow min:(gpm) [Volume/TRate]

Check if in violation of the Ohio Administrative Code 3701-31-04 (A-E); NA= Not Applicable

20

] Kiddie Slide ] Playground slide ] Rec Slide ] Water Slide ] Fountain

License no.

8772

[X]

Max allow. filter flow: (gpm) [filter label]

[ [ [ [ [

[

]

282

Max allow. flow: Jet pump capacity (gpm)

Critical violations (3701-31-04(B)(1)(a-l)

[

]

(a) Outlet covers installed/secured/ in compliance

[

]

(d) Circulation/Disinfection system operating properly

[

]

(g) Water clarity; (can see pool bottom)

[

]

(j) Pool treated after RWI

[

]

(b) SVRS devices functioning

[

]

(e) Automatic chemical controller functioning properly

[

]

(h) Natural or artificial light sufficient

[

]

(k) Proper use/storage of chemicals

(c) Disinfection residual as required

[

]

(f) Lifeguards on duty

[

]

(j) Fecal accident treated properly

[

]

(l) No Electrical hazards present

[X]

Water Quality 3701-31-04 C, D (check all that apply)

[

] Calcium Hypochlorite

[ X ] Sodium Hypochlorite

[

] Bromine

[

(D)(6)Total Chlorine-Cl2 (ppm)

1.0

[

] (C)(2) pH (7.2 - 7.8)

[

] Di-Chloro

[

[

] Salt

[X]

(D)(6)Free Chlorine-Cl2 (ppm) [>= 1; 2]

0.5

[

] (C)(3)Alkalinity (ppm) [min 60]

80

[

]

(D)(6)Combined - Cl2/ (ppm) [<= 1]

0.5

[

] (C)(6)Pool water temp (<=90F)

83

[

]

(D)(6)Total Bromine-Br2 (ppm) [>= 2; 4]

[

] (C)(7)Spa water temp (<=104F)

[

]

(D)(6)ORP/HRR (millivolts) [>= 650]

[

] (C)(8)Spa water replaced every

[

]

(D)(5) Cyanuric acid<=70ppm

] Tri-Chlor

[ ] **Monopersulfate (if present will interfere with DPD test kit results) Secondary disinfection (check if used)

[

] UV light (MJoules/cm2)

[

] Ozone (ppm)

[

] Ionization: Copper-Silver (ppm)

]

669

7.3

30 days

Responsibilities of the Operator 3701-31-04 [

]

(A) License is displayed or on file

[

]

(B)(7) No domestic animals unless otherwise permited

[

]

(D)(9) Chemicals are manually added while bathers are not present

[

]

(A) All construction or alterations of a pool done with approved plans

[

]

(d)(1) No gas chlorine for disinfection

[

]

(E)(1) Exclusion of people with obvious infectious wound or experiencing diarrhea/vomiting

[

]

(B) All facilities are maintained clean, safe and sanitary condition and in good repair

[

]

(D)(2) Pool is continuously disinfected by a feeding device connected to circulation system

[

]

(E)(2) Safety equipment is visible and accessible

[

]

(B)(2) Authorized representative available witin 30 minutes

[

]

(D)(3) Mixing tank for spray ground has disinfection

[

]

(E)(3) Appropriate signs are posted

[

]

(E)(4) Lifeguards are provided and on duty as required

[

]

(B)(3) Staff are knowledgeable of equipment and pool operation

[

]

(D)(4) Secondary disinfection device is not adversely affecting water quality

[

]

(B)(4&5) Operational records maintained and on file

[

]

(D)(7) Automatic chemical control is functioning properly

[

]

(B)(6) All equipment maintained in clean safe and sanitary condition and in good repair

[

]

(D)(8) Test kit is maintained and complete

THE ITEMS LISTED BELOW ARE IN VIOLATION OF OHIO ADMINISTRATIVE CODE CHAPTER 3701-31 AND MUST BE CORRECTED.

Cite the specific rule number, explain where and what violation has occurred, and when the violation must be corrected. 3701-31-04 B(1)(c)

The public swimming pool was operating with a disinfection residual that is less than required.

A public swimming pool shall not operate, due to an imminent health hazard, until the required disinfection residual is present. OBSERVED FREE CHLORINE LEVEL OF 0.5PPM. CHLORINE RESIDUAL MUST BE A LEVEL OF 1.0PPM OR MORE FOR SAFE SWIMMING. ENSURE THE FREE CHLORINE LEVEL IS INCREASED FOR PUBLIC SAFETY IN THE SWIMMING POOL. WILL CONDUCT A RE-INSPECTION ON OR AROUND 4/14/16 TO ENSURE FREE CHLORINE RESIDUAL MEETS PUBLIC SWIMMING POOL CODE STANDARD.

Remarks [ ] See additional remarks on the attached form, HEA 5217

Sanitarian

Phone

Jeniece Lyons SANITARIAN II #3478

PH-DMC 937-225-5911

as per HEA 5221 (Rev 4/11) Authority: Chapter 3749, Ohio Revised Code

[ X ] Yes

Re-inspection Required?

[ ] No

Operator or Representative

Compliance date

04/14/2016

Phone

Ohio Department of Health, Bureau of Environmental Health 112000983

8772

Saved

04/13/2016

1459

Printed

04/15/2016

11:30:38AM

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