Public Pool/spa Data Sheet - Ohio Department Of Health
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1
2Ohio Department of Health
ODH file no
Public Pool/Spa
Type of project
Construction type
Data Sheet
Outdoor
Indoor
Special
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1.
Pool
5.
Pool
9.
Special use pool
1.
New
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2.
Spa
6.
Spa
10.
Special feature
2.
Renovation
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3.
Wading pool
7.
Wading pool
11.
____________________
(See C. of Instructions)
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4.
Diving pool
8.
Diving pool
Action governed by
Ohio Revised Code Chapter 3749
County
Local health district
Project name
Designer
Street address
Street address
City
Township
City
Township
Phone
Phone
ZIP
ZIP
(
)
(
)
Owner
Contractor
Street address
Street address
City
Township
City
Township
Phone
Phone
ZIP
ZIP
(
)
(
)
Instructions
A. Print clearly
D. Where a component is not used or does not exist label that section
B. Original and four (4) copies required.
“N/A”—Not Applicable.
C. Complete all sections to provide full information. For renovation work
E. Describe work to be done in Section 14- “Remarks”
always complete section 01: check each section ‘New’ or ‘Existing’.
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01. Design Geometry
f. Flow measuring device _______________________
07. Overflow
New
Existing
Range ______________________________________
a. Pool/Spa surface area
a. Skimmers
Note: Provide vertical loop (12 inch minimum above top
b. Deck surface area
1. Make/Model no. ___________________________
of pool) for air blower to prevent shock hazard.
c. Total area
2 Number __________________________________
d. Pool Spa volume
3. Equalizer (equalizer valve required)
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04. Filtration
New
Existing
e. Required turnover period
a.) Depth below operating level ___________in.
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a. Filter type
Sand
D.E.
Cartridge
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Pool-480 min.
Wading pool-120min.
b. Gutters
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Pressure
Vacuum
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Spa-30 min.
Other ______________min.
1. Make/Model no.___________________________
b. Make/Model no. ____________________________
f. Minimum required flow rate (Id / 1e)________gpm
2. Number of drain/collector boxes_____________
c. Number
Elements ______Filters ______
g. Normal operating flow rate ________________gpm
3. Open area each box _______________________
d. Area of each
Elements ______Filters ______
h. Maximum operating flow rate______________gpm
4. Number of return boxes____________________
e. Total filter area____________________________sf
f. Commercial filter design flow rate
5. Available surge capacity (gallons)
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02. Recirculation Pump
New
Existing
____________________________________gpm/sf
Surge tank ________________________________
a. Make/Model no. _____________________________
g. Maximum allowable filter flow
Pool______________________________________
b. H.P. _______________________submit pump curve
(4e x 4f) _______________________________gpm
Gutters ___________________________________
c. System total dynamic head
Total _____________________________________
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05. Main Drain
New
Existing
(usually 40-60ft.) ___________________________ft.
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a. Anti-Vortex grates
Yes
No
d. Pump capacity (at TDH in 2c) ______________gpm
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08. Return Inlets
New
Existing
b. Make/Model no. ____________________________
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e. Hair/Lint strainer
Yes
No
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a.
Wall
Integral gutter
c. Size/Dimension ___________________________in
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f. Throttle valve required?
Yes
No
1. Depth below operating level ______________in.
d. Each grate open area ___________________sq-in
limit flow ____________________________gpm
2. Spacing _________________#________________
e. Velocity thru grate at 100% of 2d __________fps
b. Floor (space uniformly)_______________________#
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03. Other Pumps
New
Existing
f. Maximum allowable flowrate ____________gpm
a. Make/Model no. _____________________________
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06. Other Suction Drains
New
Existing
09. Piping
New
Existing
b. H.P. _______________________submit pump curve
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a. Anti-Vortex grates
Yes
No
a. Type Material ________________________________
c. System total dynamic head
b. Make/Model no. ____________________________
b. Schedule or S.D.R. no. ________________________
(usually 40-60ft.) ___________________________ft.
c. Size/Dimension ___________________________in
c. A.S.T.M. no. _________________________________
d. Pump capacity (at TDH in 3c) ______________gpm
d. Each grate open area ___________________sq-in
d. Other _______________________________________
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e. Throttle valve required?
Yes
No
e. Velocity thru grate at 100% of 3d __________fps
Note: All pipe shall be clearly labeled.
limit flow ____________________________gpm
f. Maximum allowable flowrate ________________
HEA 5214 (Rev. 2/03)
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