FY 2016 SWIMMING POOL PERMIT RENEWAL AND FEE NOTICE

Dear Pool Operator,

The pool operator/owner/manager must complete and return to the Durham County Department of Public Health the attached
Application for Operation Permit and make payment fee of

$250 for each pool, wading pool, or spa at the facility.

Checks should be made payable to the Durham County Department of Public Health (Tax ID # 56-6000297) and
returned with the completed application(s). Corporate checks mailed directly to the Durham County Department of Public
Health separate from the applications must clearly note on the check the facility name and permit number(s) for each pool for
which payment is being made. Facilities with multiple pools may total fees due and write one check.
COMPLETED APPLICATIONS AND CHECKS CAN BE RETURNED IN PERSON OR BY MAIL TO THE:
DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH
ENVIRONMENTAL HEALTH DIVISION
414 E MAIN STREET
DURHAM NC 27701
ATTN: SWIMMING POOL PROGRAM
OR APPLICATIONS FAXED TO 919-560-7830 OR EMAILED TO healthinspector@dconc.gov
AND FEES PAID BY VISA OR MASTERCARD AT 919-560-7800

IMPORTANT INFORMATION AND RENEWAL INSTRUCTIONS ON BACK OF NOTICE

A SEPARATE COMPLETE APPLICATION MUST BE PROVIDED FOR EACH POOL PERMIT

NUMBER
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
FIRST CONTACT TO SCHEDULE A PERMITTING VISIT MUST BE MADE VIA EMAIL AT
HEALTHINSPECTOR@DCONC.GOV

Environmental Health Division

Human Services Building | 414 East Main Street, Durham, North Carolina 27701
(919) 560-7800 | Fax (919) 560-7830 | dconc.gov/publichealth
Equal Employment/Affirmative Action Employer

THE OPERATOR FOR THE POOL FACILITY IS RESPONSIBLE FOR CONTACTING THE
ENVIRONMENTAL HEALTH DIVISION VIA healthinspector@dconc.gov TO SCHEDULE A PERMITTING
INSPECTION OF THE POOL(S) BEFORE OPENING THE POOL(S). Pools cannot operate without a valid
Operation Permit. Inspections will be scheduled ONLY when the Environmental Health Division has received a
completed application and fee payment.
All pools must be VGB compliant. Maximum pump flow cannot exceed drain cover rating.
Seasonal pools (operation is limited to April 1 through October 31) should be ready and opening inspections
scheduled at least one week prior to the proposed opening date. The pool must be in normal operating condition;
that includes, clear, chemically balanced water, safety equipment properly displayed, depth markers and no diving
warnings provided as required, operable emergency telephone, etc.
Time, budget, and staffing concerns will not permit waiting on site for deficiencies to be corrected or for same day
return inspections.
Any pools unprepared for inspection or denied permits will not be re-scheduled until a $50 re-inspection fee has
been paid.

Year Round Pools

Applications and fees should be returned to the Durham County Department of Public Health, Environmental Health
Division 30 days prior to permit expiration date.
Once applications and fees have been received in the Environmental Health Division, unannounced inspections will
be within 10 business days.
ALL POOLS

A reminder A certified pool operator must visit the pool daily and complete the daily pool check sheet.
A reminder - Chlorine and pH are to be read and recorded in the pool log daily. Alkalinity and Cyanuric Acid levels
read and recorded weekly.
A reminder - After dark swimming is only allowed if the pool meets the provisions of 15A NCAC 18A Section .
2524. Contact Environmental Health Division to request an after dark inspection to determine if the pool meets the
lighting requirements.
Seasonal Pools
THE OPERATOR FOR THE POOL FACILITY IS RESPONSIBLE FOR CONTACTING THE
ENVIRONMENTAL HEALTH DIVISION VIA EMAIL healthinspector@dconc.gov TO SCHEDULE A
PERMITTING INSPECTION OF THE POOL(S)

Pool Program Coordinator

The contact information for swimming pool related concerns is John Williams at 919-560-7800 or by email at
jcwilliams@dconc.gov
.

Office Use Only

Date Rec ____/____/2016

Seasonal/Year Round

Date Paid____/_____/2016

50/53 Pool $250 each pool

51/54 Wading Pool $250 ea.
52/55 Spa $250 ea.

Amount $_________
Cash Credit

Check #_________

2016
PUBLIC SWIMMING POOL OPERATION PERMIT APPLICATION
POOL INFORMATION
POOL/FACILITY NAME _____________________________________
STREET ADDRESS OF
POOL________________________________CITY________________NC_ZIP_______
PHONE # OF POOL EMERGENCY
PHONE_______________________________________________________
PERMIT #04-032-____-______

POOL OPERATIONS (circle) YEAR ROUND or SEASONAL

TYPE OF DISINFECTANT (circle) CHLORINE

BROMINE CL2 GENERATOR (SALT)

VGB SAFETY COMPLIANCE DATA

Circulation Pump System Flow
Pump Manufacturer ______________________Model Number
__________________Horsepower________
Maximum Pump Flow (manufacturers specifications) _____________gallons per minute
OR
Provide supporting evidence for flow reduction by a North Carolina Registered Professional
Engineer.
Feature Pump/ Spa Jet Pump System Flow (indicate N/A if Not Applicable)
Pump Manufacturer _____________________ Model Number
__________________Horsepower________
Maximum Pump Flow (manufacturers specifications) _____________gallons per minute
Main Drain Cover/Grate Data
Number of drains on same pumping system ________ Distance between drains (on centers)
__________

Environmental Health Division

Human Services Building | 414 East Main Street, Durham, North Carolina 27701
(919) 560-7800 | Fax (919) 560-7830 | dconc.gov/publichealth
Equal Employment/Affirmative Action Employer

Cover/grate manufacturer ____________________________, model

_____________________________
Maximum flow rating of cover/grate__________________ gpm (floor)
Date drain cover/grates installed: ______________________________ Expiration date:
_________________
Application Page 1 of 3

Feature Drain Cover/Grate or Spa Jet Drain/Grate

Number of drains on same pumping system ________ (indicate 0 if NONE)
Distance between drains (on centers) __________
Cover/grate manufacturer ____________________________, model
_____________________________
Maximum flow rating of cover/grate__________________gpm (floor); __________________ gpm
(wall)
Date drain cover/grates installed: ______________________________ Expiration date:
_________________
Skimmer Equalizer Cover Data
Number of operable skimmer equalizers________ (indicate 0 if NONE)
Equalizer fitting Manufacturer__________________________,
model______________________________
Equalizer fitting maximum flow rating ____________________
Date equalizer cover/grates installed: ________________________ Expiration date:
___________________
Safety Vacuum Release System (SVRS) SVRS required if dual drains are closer than
3 feet on center or pump has a single drain with blockable cover or sump. (Single drain
pools must also have at least 1 functioning skimmer.) Indicate N/A if not applicable.
Safety Vacuum Release System manufacturer ____________________________________________________
Full name of person providing this information
____________________________________________________

N.C. Division of Environmental Health

Environmental Health Services Section

Updated November 17, 2009

FACILITY OWNER OR LOCAL MANAGEMENT INFORMATION

NAME OF OWNER/MANAGEMENT
COMPANY__________________________________________________
MAILING ADDRESS
_________________________________________________________________________
CITY____________________________________________ STATE__________________ ZIP
CODE_________
CONTACT PERSON______________________________ OFFICE PHONE
NUMBER_____________________
FAX NUMBER___________________________________ EMAIL _________________________________
BILLING ADDRESS FOR RENEWAL APPLICATION & ANNUAL FEE NOTICE IF DIFFERENT
FROM ABOVE
NAME ____________________________________________________________________________________
ADDRESS_________________________________________________________________________________
CITY_____________________________________ STATE _________________ ZIP
CODE________________
EMAIL ____________________________________________
2 of 3

Application

Page

FACILITY/POOL IS OPERATED/MANAGED BY (Check One)

POOL OPERATORS EMAIL ______________________________________________________

POOL OPERATOR TRAINED ON-SITE STAFF

A CONTRACTED POOL MANAGEMENT COMPANY
A SHARED ARRANGEMENT BETWEEN CONTRACTED POOL COMPANY AND ON-SITE
STAFF

ON-SITE STAFF/OPERATOR(S) IF APPLICABLE

Environmental Health Division
Human Services Building | 414 East Main Street, Durham, North Carolina 27701
(919) 560-7800 | Fax (919) 560-7830 | dconc.gov/publichealth
Equal Employment/Affirmative Action Employer

NAME___________________________CERTIFICATE NUMBER ______________ EXP DATE

_____/____/_____
NAME___________________________CERTIFICATE NUMBER ______________ EXP DATE
_____/____/_____
NAME___________________________CERTIFICATE NUMBER ______________ EXP DATE
_____/____/_____

POOL COMPANY INFORMATION

POOL MANAGEMENT COMPANY____________________________________________________________
MAILING ADDRESS ________________________________________________________________________
CITY_______________________________________ STATE ____________________ ZIP
CODE___________
CONTACT PERSON_________________________________ PHONE
NUMBER________________________
FAX NUMBER______________________________________ EMAIL _________________________________
LOCK BOX COMBINATION ___________________________ LOCATION____________________________

________________________________
Signature

_____________________________ _________________________
Print Name

Date

Application Page 3 of 3