1. Owner/Operator of Pool:________________________________________________________________2. Establishment:________________________________________________________________________3. Location: Street ________________________________Town or City:___________________________4. Owner Mailing Address:________________________________________________________________Town ___________________________________State ______ ZIP Code _______________________Telephone: ________________________________ E-mail: ___________________________________
5. Location of Pool/Spa: Indoor [ ] Outdoor [ ]6. Capacity in Gallons :_________________7. Dimensions for In-Ground Pool: Length ______FT. Width _______FT. Surface Area :______ FT2Greatest Depth :________FT. Minimum Depth :________FT. Maximum Bottom Slope __________ %
Dimensions for Above Ground Pool: Round : Depth __________ FT Diameter ____________ FT
Greatest Depth :________FT. Minimum Depth :________FT. Maximum Bottom Slope __________ %
Square or Rectangular: Length _________FT. Width _________FT. Surface Area :________ FT2
Greatest Depth :________FT. Minimum Depth :________FT. Maximum Bottom Slope __________ %
8. Dimensions for Spa: Depth _______________ FT Diameter ________________ FT9. Recirculation Pump Capacity: __________ GPM10. Turnover Rate in Hours: _____HRS.11. Type of Filter (Check One)Sand Filter [ ] High Rate Sand Filter [ ]
Diatomaceous Earth [ ] Cartridge Filter [ ]
Other, specify: _______________________________________________
Loading rate: Recirculation Rate _________ GPM/SQ. FT. Filter Area _____________ SQ. Ft.
12. Method of Filter Backwash Disposal:_____________________________________ If other than public sewer, provide an HHE-200 Form (Subsurface Wastewater Disposal System Application).
13. Diameter of Recirculation Piping _____________ (inches)14. Number of Skimmers:____________ (1 PER 500 SQUARE FEET required.)15. Size of Gutter:_________ (REQUIRED IF POOL SURFACE AREA IS GREATER THAN 1,600 SQUARE FEET)16. Height of Board (if any) :________ Depth of water 12 feet beyond end of board :______________REQUIRED: 8 FEET, 6 INCHES FOR 2-FOOT BOARD HEIGHT OR LESS; 10 FEET FOR 1 METER BOARD HEIGHT OR LESS.
Purification Equipment:_________________________________________________________________
Amount of Chemicals Used per Day, in pounds:
Chlorine:__________ Alum:____________ Soda Ash: __________ Other: _______________________
17. Fresh Water Supply Source______________________________18. Average Bathing Load per day:___________________________Number of Showers _____ Location :_____________________
Number of Toilets:_______ Urinals _____ Location:__________________
SIGNATURE:______________________________ DATE:___________________
Public Swimming Pool and Spa Registration Instructions
When submitting an application for review of a public swimming pool to the Department, the applicant and/or designer must include the following for a complete application:
(1) A completed Department Swimming Pool Registration Form.(2) Plan(s) of the pool showing depths, area, piping, and safety features, complying with the ANSI/National Spa and Pool Institute's Minimum Standards for Public Swimming Pools. If plans for existing in-ground pools are not available, complete the sample pool diagram page. For above ground pools, omit the plan, but be sure to include the dimensions in the application form.(3) Plans and/or manufacturer's specifications for pumps and filtering equipment.(4) A complete HHE-200 (Subsurface Wastewater Disposal System Application) if a separate building for showers and/or toilets are associated with the pool or spa OR if the pool backwash discharges to a subsurface system. For existing systems installed after 1974, check with your Town Office, or apply for a record search. Systems older than 1974 have no records, and a new design is necessary.(5) A review fee of $15.00 is required. A check or money order must be made payable to the "Treasurer of State" and submitted.(6) A pre-operational inspection is required. The Department must be notified at least 15 days in advance of placing the pool or spa in operation to allow for inspection and approval. Upon receipt of all of the above, we will review your request. Please allow a minimum of 30 working days for the review.
If you have any comments or questions, please feel free to contact us.
Plan Review
Subsurface Wastewater Unit - DWP Division of Environmental Health Maine Center for Disease Control & Prevention Department of Health and Human Services 286 Water Street, 3rd Floor Augusta, ME 04333
(207) 287-5672 | Inspection & Operation
Health Inspection Program Division of Environmental Health Maine Center for Disease Control & Prevention Department of Health and Human Services 286 Water Street, 3rd Floor Augusta, ME 04333
(207) 287-5671 |
IN-GROUND SWIMMING POOLS
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C.M.R. 10, 144, ch. 202, app 144-202-E