HomeMy WebLinkAboutApplication Misty Meadow Lane sw•r �, Town of South Windsor — Health Department
rL �� 1540 Sullivan Ave., South Windsor, CT 06074- Mailing Address
1530 Sullivan Ave., South Windsor, CT 06074-Office Address
Phone Number: (860) 337-6173, Fax Number: (860) 644-1930
PUBLIC SWIMMING POOL REGISTRATION FORM
FACILITY NAME tQ O t r'4fi3O
ADDRESS: r
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PHONE: EMAIL:
OWNERIASSOCIATION
REPRESENTATIVE: // ��� n CC S // C-/6tO-)i-7
ADDRESS , o Z �fit7 rr1 it ;Xivt (�- �dX7! (� O G/ar—
PHONE Rod Q _EMAIL C/ r t m A �e_ y
MANAGER(if different from owner):
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ADDRESS _O�bClLk
PHONE NUMBER: A�ad EMAILdy�AnrjtZ,Z�_@lmAf�� C•C
POOL
OPERATOR: �J_ACk tJc1 /-
ADDRESS
PHONE NUMBER a0 - -1J'.& y EMAIL ` �c l�.ac� C� /h%-/-
FACILITY INFORMATION:
Check all that apply:
Indoor Pool Outdoor Pool Wading Pool Whirlpool/Spa
Dates Pool is Open: From ��.�? to _ g/1/
Pool Capacity
Pool Make-up Water Source: Public X Private
Disinfectant Used
The undersigned agrees to comply with Section 19-13-B33b of the Connecticut Public Health Code:
Sig lure o t Title Date
RECEIVED
*Please return completed registration form to the South Windsor Health Department. Pool inspection requests. u,t b+L%nl f�2 weeks
prior to anticipated pool opening date
SOUTH WINDSOR
HEALTH DEPT.
Collelo, Diane
From: Debra Yannizze <DYannizze@imagineersllc.com>
Sent: Thursday, May 11, 2017 2:47 PM
To: Collelo, Diane
Subject: Re: Pools in South Windsor
Diane
Attached is the pool permit form for Burr Meadow.
I will have you documentation for the Virginia Graeme drain cover after the pool is clean and Savol pools install. We
were due for a new one this year
Debbie
On May 5, 2017, at 1:54 PM, Collelo, Diane<Diane.Collelo@southwindsor.org>wrote.
Good Afternoon,
I am sending this email as a reminder to be sure to send in your pool registration form and schedule
your opening pool inspection. If you have already done this please disregard this message.
I have attached the pool registration form. Please fill it out at your earliest convenience and email or
mail it to the address in the tag line below.
Should you have any further questions please do not hesitate to contact me.
Regards.
Dl 2 v'e L. CoUeLo, 1zEHS/RS
Ev,,\Arov v1AevLt�2L a--te2Lth Spec,,r2L�st
Town of South Windsor, Health Department
1540 Sullivan Avenue—Mailing Address
1530 Sullivan Avenue --Office Address
South Windsor, CT 06074
Office Hours:
Monday& Thursday 8:15-4:00
Tuesday, Wednesday, Friday 8:15-4:30
Ph.: 860-337-6182
Fax: 860-644-1930
www.southwindsor.org
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https://www.facebook.com/SouthWindsorHealth Department
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