HomeMy WebLinkAboutApplication Candlewood Drive OLO oyr� Town of South Windsor — Health Department
M■ a(
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: f ,(L-L rR t &C- M £ S
ADDRESS: Q R-0T)L-F_ u)-P �Ve- CT 0007L/
PHONE: R60 S�� S k a EMAIL
OWNER/ASSOCIATION
REPRESENTATIVE: C(�
�4'4
t�S � h/ qC'1q% Wes,
�l(e Sot c 6tc-lin(4 C7— Q60 C
PHONE: o ( O S cif 5 X EMAIL:
MANAGER (if different from owner):
_SQw o
ADDRESS:
PHONE NUMBER: EMAIL:
POOL
OPERATOR: I
ADDRESS �i ; �dt�.,� fr` S(y Sr LJ)h Jsci0— C- ( O�C7 7V
PHONE NUMBER � C' �� � � EMAIL Sb (c(S (4,n cvis')'16
r
FACILITY INFORMATION:
Check all that apply: /
Indoor Pool Outdoor Pool v Wading Pool Whirlpool/Spa
Dates Pool is Open: Frog,i R(I Z(o ZO l to (0 Zc( 1
Pool Capacity: rj, UCH
Pool Make-up Water Source: Public t__ Private
Disinfectant Used Q_ ,(''-t V `
The undersigned agrees to comply with Section 19-13-11333b of the Connecticut Public Health Code:
Signature of Applicant Title / Date
RECEIVED
'Please return completed registration form to the South Windsor Health Department. Pool inspection requests rrtp*k0esctjeduled 2 weeks
prior to anticipated pool opening date. iH U l U 17
SOUTH MNDSOR
HEALTH DEpr
Print Document https://view.invoiceasap.com/print.php?invoiceid=Ilik2y8rbc
Estimate
Splash Pool Supply Estimate Number: E170413116
nick@splashpoolsupply.com Estimate Date: 04/13/2017
Payment Terms: Due On Receipt
Estimate Amount: 7,013.78
Created By: Nick Healy
Bill To Ship To
Mill River Mill River
Item# Item Name Quantity Unit Price Taxable Total
Remove Plumbing And Re Install Plumbing To Meet
1068 Code.
Includes all plumbing Materials 1.00 1,595.00 X 1,595.00
2 year warranty on all plumbing
1
13hp Pentair Variable Speed Motor
1069 2 year warranty 1.00 1,775.00 X 1,775.00
This motor is equiped with a vgb internal system
covering all required codes.
Remove Main Drain Covers And Reinstall New Covers
1070 To Meet Code 1.00 225.00 X 225.00
Includes all materials
I
Install Versa Chlor System At The Same Time As New
1071 Plumbing For Pump And Filter 1.00 1,350.00 X 1,350.00
2 year warranty
i
1072 Install Versachlor System After New Plumbing Installed 1.00 71,650.070 X 1,650.00
Comment: Subtotal: $6,595.00
Mill river 65000 gallon pool,currently up to code with Ct Rate: 6.35%
vgb using stratum system. Ct Amount: 418.78
Estimate Amount $7,013.78
New variable speed pump will eliminate need for 3
pumps and reduce energy costs.
of 1
n11-11lni� ii.ec ewer