Fill - Free fillable SWIMMING POOL PLAN CHECK SHEET (California) PDF form

Page 1 of 14

Title 22 of the California Code of Regulations requires that any person constructing, reconstructing, or altering a

swimming pool, auxiliary structure or equipment submit legible plans and specifications to the enforcing agent, San Luis

Obispo County Environmental Health for review and written approval prior to commencing work or issuance of

necessary building permits [Section 65505] THIS CHECKLIST IS DESIGNED TO ASSIST THE APPLICANT IN THE PREPARATION OF

SATISFACTORY PLANS. As it does not become part of the completed plans, please ensure all required information appears

on the plans.

A new swimming pool (commercial) located in the unincorporated area must first receive clearance from the County

Planning (Zoning) Department.

The following must be submitted to Environmental Health in duplicate. One set will be returned with a list of

corrections or stamped as approved.

1. Drawings to scale (pool: ¼” = 1 foot) of the pool in both overhead plan view and longitudinal section and, where

there are diving boards, transverse section.

2. Drawings to scale of the equipment room, equipment, plumbing and electrical with each item identified and piping

sizes specified.

3. Drawings to scale of the deck area including drainage, fencing and gates, hose bibb and drinking fountain locations.

4. Drawings to scale of restrooms, shower and locker areas (including room finishes) when appropriate.

The following must also be submitted at the time of application for each pool:

1. Specification sheets for all pool equipment including pumps (with pump curves), filters, skimmers, chlorinators,

heaters, flow meters, separation tanks, lights, and hand rails.

2. The following list of items [pages 2-12] must be completed, signed and dated by the pool contractor/designer. All

pool and equipment data must be shown on plans submitted.

IDENTIFICATION:

Name of Facility Where Location/Address City

Pool to be Constructed:

Owner Address Phone

Contractor/Designer Address Phone

SWIMMING POOL PLAN CHECK SHEET

Page 2 of 14

Person to Contact Regarding Plans Phone

POOL DATA – Part I of ll

ANSWER THE FOLLOWING QUESTIONS WHERE APPLICABLE

AND CHECK THE APPROPRIATE BOX(s):

1. TYPE OF POOL (Check):

 _____ standard (no diving)

 _____ standard (diving)

 _____ wading

 _____ special use/other

Specify________________________

2. POOL DIMENSIONS:

 Length _____________________________

 Width _____________________________

 Diameter___________________________

 Surface Area _______________________

 Min. Depth _________________________

 Max. Depth_________________________

 Aver. Depth________________________

 Volume (gals.)______________________

 Odd configuration, see plan _________

 Complies with Sect. 2.9011(see Pg.5)

3. POOL COLOR MUST BE WHITE ____yes

4. RETURN INLETS: (Provide spec sheet)

 # of inlets __________________

 Size of inlets __________________

 Inlets adjustable _______________

5. OUTLET BOTTOM DRAIN: (Provide spec sheet)

 Safety type dual main drains at least 2 feet

apart

 Open area of the drain cover _______ sq. in. =

________sq. ft.

 Size of piping: ____________________

 GPM (from pump curve) per grate (1/2 of GPM

if 2 grates) _____  7.48 gal./cu. ft. = _____ cfm

 60 sec/min = ____ cfs  grate opening in sq.

ft. (sq. in 144) = ________fps. (Must be less

than 2 ft./sec)

5. SUCTION LINE SIZE: _______________

6. PUMP: (Provide spec sheet)

 Manufacturer ______________________

 Model # ________________

 Horsepower ______________________

 # of pumps _______________

 Ft. of head in system ______________

 GPM @ system head loss __________

 Turnover rate _________________

 Hair & Lint catcher ___ Yes ___ No

7. FILTER: (Provide spec sheet)

 Type ____________________________

 Manufacturer _______________________

 Model # ________________

 Area in sq. ft. _____________________

 # of filters __________________

 Total Area _________________ sq. ft.

8. HYDROSTATIC RELIEF VALVE/ASSEMBLY:

____ Yes ____ No

 Depth to groundwater _________________

9. CHLORINATION OR DISINFECTION UNIT

(Provide spec sheet)

 Type of unit _______________________

 Manufacturer _______________________

 Model # _________________

10. SKIMMER/GUTTER SYSTEM:

(Provide spec sheet)

 # of skimmers ________________

 Manufacturer ________________________

 Model # __________________

 Gutter system with surge tank at

________________ gallons

11. FLOWMETER: (Provide spec sheet)

 # of flow meters ___________________

 Manufacturer _______________________

 Model # _________________

12. RANGE OF PRESSURE GAUGE:

Influent ________ Effluent ________

13. VACUUM GAUGE: _________________

14. POOL STEPS/STAIRS/LADDERS/RAILS:

 Pool is _____ ft. at shallow end

 Riser height of stair ____________

 # of safety rails ________________ (Provide

spec sheet)

 Height of rail above deck ____ in.

 # of ladders ______________

 Clearance between ladder and stair riser

_______ in.

 Stepholes have a tread of _____ in. and a width

of _____ in.

15. DEPTH MARKERS:

 _____ maximum depth

 _____ minimum depth

 _____ each end

 _____ break in slope

 _____ perimeter at 25 ft. increments

 _____ vertical wall of pool at water line

Page 3 of 14

 _____ vertical wall of pool & on deck

surface (if pool width exceeds 20 ft.)

 _____ markers are _____ in. in ht.

 _____ “Ft.” abbreviation after each

depth marker

16. BREAK MARKING:

 Pool has a break in slope at 4 ½ feet ____No

___Yes (If yes: 1 & 2)

POOL DATA – Part I OF II (continued)

1. Proper flush mounted devices for fastening a

safety rope & buoys across pool (at 4 ½ ft.

depth) installed ___Yes ___No

2. Break-in depth slip resistant 4 in. tiles

___ Yes ___ No

17. DECK:

 Deck is made of _____________________

 Deck is _____ ft. wide

 Deck is _____ ft. wide between pool and spa

 Deck is sloped ¼”/ft. to deck drain

___ Yes ___ No

 Deck drains to _______________________

18. COPING:

 Type ______________________________

 Manufacturer ________________________

19. FENCING:

 Does fencing enclose pool?

 What is its height?

 Are any openings greater than 4 in. in any

dimension?

 Does the gate have a self-closing self-latching

lock? Opens outwardly

20. EQUIPMENT ROOM:

 The floor is made of __________________

 Is there easy access to all equipment and

gauges? ___________________________

 Have provisions been made for a back wash

sight glass? ____________________

 Is floor sloped ¼”/ft. to a drain? ______

21. DRESSING ROOM/TOILET/SHOWER:

 Straight line distance from above to farthest

point of the farthest living unit ________ ft.

 Are public showers, toilets and dressing rooms

provided? _____________________

 Total # of bathers is _________________

 Is one shower per 50 bathers provided?

___ Yes ___ No

 Separate toilet facilities for men and women are

provided as follows:

 # of women toilets _________

 # of men toilets _________

 # of men urinals _________

 # of women showers _________

 # of men showers ________

 # of women lavatories ________

 # of men lavatories ________

 Hot water max. temp. is _______ F.

23. DRESSING ROOM/TOILET/SHOWER FLOOR PLAN

REQUIREMENTS:

 Dressing room/toilet/shower floor plan

provided

 Room finish schedule provided

 Wall material

 Floor material, floor must be coved

 Ceiling material

 Samples of flooring and wainscot materials are

provided

 Hot & cold running water to each faucet

 Hot water must reach 110 F minimum

24. HOSE BIBBS/DRINKING FOUNTAIN:

 Has a hose bibb been provided that is located

so that all portions of the deck can be reached

with 75 ft. of hose? _____

 There is/are _______ drinking fountain(s).

25. SIGNS: The following signs will be posted at pool

side:

 _____ No Lifeguard on Duty

 _____ Lifeguard on Duty

 _____ Artificial Respiration

 _____ No Diving Sign (Shallow pool)

 _____ Chlorine Gas

 _____ Emergency Phone Numbers

 _____ Pool Occupancy Capacity

26. SAFETY EQUIPMENT:

 _____ Life hook and pole

 _____ Life ring with 3/16” rope

 _____ First aid kit

 _____ Test kit (pH, free chlorine &

cyanuric acid)

27. BACKWASH:

 Separation tank ___ Yes ___ No

Page 4 of 14

Make/model ___________________ capacity to

_____ sq. ft. of filter area

 Wastewater from the separation tank cannot be

returned to the pool.

 Air gap filter backwash to public sewer

___ Yes ___ No

 Backwash receptacle size _____ p-trap size

_____________

 Backwash valve ___ Yes ___ No

____ size Make/Model

________________

Backwash water goes to ______________

28. WHEN EMPTIED, POOL WATER GOES TO

_____________________________________

POOL DATA – Part I OF II (continued)

29. HEATER: (Provide spec sheet)

 Manufacturer

 Model _____________ connection pipe size

_______ in.

 Max. flow _______________________

 Internal bypass valve ___ Yes ___ No

 External bypass valve ___ Yes ___ No

Size of bypass ___________ in.

30. RECIRCULATION PIPE SIZE:

POOL DATA – Part I of II (continued)

ANSWER THE FOLLOWING QUESTIONS WHERE APPLICABLE

AND CHECK THE APPROPRIATE BOX(s):

DO THE FOLLOWING CALCULATIONS, SHOW ALL WORK; ATTACH SEPARATE SHEET AS NEEDED:

I. GALLONAGE CALCULATION:

 length (ft) x width (ft) x average depth (ft) x

(times) 7.5 gal/ft

= # of gallons

Answer: _____________________ gal.

 For Round Pools:

3.14 x R

(ft) x average depth (ft) x 7.5

gal/ft

= # of gallons

Answer: _____________________ gal.

II. PUMP CURVE CALCULATIONS:

____________ gpm from pump curve at

_______ ft. of head

 60 ft. of head for pressure D.E., high rate

sand & cartridges

 45 ft of head for rapid sand

 40 ft of head for vacuum D.E.

III. TURNOVER CALCULATIONS:

Pump must provide a complete turnover of pool

water in a 6 hour period.

 gallons in pool = min. gpm of pump 360

min.

 __________ = ____________

360 min. (answer)

 Gallons in pool x 6  pump curve gpm x 360

= __________________ turnover rate in

hours

IV. MAX. FILTRATION FLOW RATE CALCULATIONS:

(Complete for your filter type)

 Rapid sand: 3 gpm/ft

______________ gpm (pump curve)

3 gmp/ft

= _______________ ft.

filter required

(answer)

 D.E.: 2 gpm/ft

____________ gpm (pump curve)

2 gpm/ft

= _______________ ft.

filter required

Page 5 of 14

(answer)

 High Rate Sand: 15 gpm/ft

_______________ gpm (pump curve)

15 gmp/ft

= _______________ ft.

filter required

(answer)

 Cartridge: 0.375 gpm/ft

____________ gpm (pump curve)

0.375

= _______________ ft.

filter required

(answer)

Recommend increasing filter area by 25%

V. SKIMMER CALCULATIONS:

 1 Skimmer/500 ft

surface area

_________ ft

(pool surface)

500 ft

/skimmer

= __________________________

(# of skimmers)

VI. SURGE TANK CALCULATION:

__________________ ft

(pool surface)

1 gal/sq. ft.

= _______________ gal.

(of surge tank)

VII. INLET CALCULATIONS:

 2 per first 10,000 gal.

 1 per each 10,000 gal. Thereafter:

(1) ________ gal – 10,000 gal

= 2 inlets

(2) ________ (remainder)

10,000 gal

= additional inlets

_____________ (1) + _____________

(2) = _____________ total inlets

 Total inlets = ___________________

PART II OF II

ANSWER THE FOLLOWING QUESTIONS:

3106B

Pool shall be designed and durably built of reinforced concrete, or material equivalent in strength

and be watertight.

____ Yes Show on plans

3106B

The finished pool shall be white.

____Yes Show on plans

3106B

Pool is free from projections and recessed areas.

____ Yes Show on plans

3107B

If temporary training pool (2-9012) (Answer a-d below)

____ Yes ____ No ____ Not Applicable Show on plans

a. Complies with Section 2-9011

____ Yes ____ No ____ Not Applicable Show on plans

b. Installed on paved level surface which extends at least 10’ beyond pool walls.

____ Yes ____ No ____ Not Applicable Show on plans

c. Provided with a solid cover that will support 40 lbs/sq. ft.

____ Yes ____ No ____ Not Applicable Show on plans

d. Pool and cover designed by a registered engineer.

____ Yes ____ No ____ Not Applicable Show on plans

3108B

Geometry of pool conforms to one of the appropriate diagrams in figures 31B 1 through 31B 3.

____ Yes ____ No ____ Not Applicable Show on plans

Page 6 of 14

3108B

Pool has a change (Break) of slope from shallow to deep end.

____ Yes ____ No Show on plans

3108B

Pool has flush mounted fastening devices for fastening a safety rope and buoys across the pool

where water depth is 4 ½ ft.

____ Yes ____ No ____ Not Applicable Show on plans

3109B

There is a 4 inch wide straight line of slip resistant tile across the bottom of the pool at the 4 ½ ft.

depth mark.

____ Yes ____ No ____ Not Applicable Show on plans

3109B

There can be no designs resembling a human form on the walls or bottom of the pool. Are any

graphics planned on the interior finish? ____ Yes Show on plans ____ No

3109B

#10

The water depth is clearly marked at the following locations (circle letter preceding your answer):

a. Maximum depth * Wading pool must have 2 depth markers

b. Minimum depth indicating maximum depth

c. Each end

d. Break in slope

e. Perimeter at increments not exceeding 25 ft.

f. On vertical walls at/or above water level

Show on plans

PART II OF II (continued)

3109B

#11

Pool is greater than 20 ft. wide and has depth markers also on edge of deck.

____ Yes ____ No Show on plans

3109B

#12

Depth markers must be least 3 in. in height, of contrasting color, made of durable material that

resists weathering (slip resistant if located on the deck). Also, the abbreviation “Ft” (3 inches in

height) must appear after each depth marker.

____Yes Show on plans

3109B

#13

Width of lane markings doesn’t exceed 12 inches.

____ Yes ____ No ____ Not Applicable Show on plans

3110B

#14

Depth of shallow end of pool exceeds 2 ft. and requires steps and ladders.

____ Yes ____ No Show on plans

3110B

#15

Depth at deep end of pool exceeds 4 ½ ft. and requires ladders.

____ Yes ____ No Show on plans

3110B

#16

Pool exceeds 30 ft. in width and requires ladders on both sides at increments not exceeding 100 ft.

____ Yes ____ No Show on plans

3110B

#17

Minimum tread of stairs is 12 inches or greater.

____ Yes ____ No Show on plans

Page 7 of 14

3110B

#18

Riser height of stairs does not exceed 12 inches.

____ Yes ____ No Show on plans

3110B

#19

The top step is curved convexly and top step tread is 18 inches or greater in size.

____ Yes ____ No ____ Not Applicable Show on plans

3110B

#20

The required ladders have a handhold that is corrosion-resistant and equipped with slip-resistant

tread. It will be rigidly installed and provided a clearance of not less than 3 inches nor more than 5

inches between part of the ladder and the pool wall.

____ Yes ____ Not Applicable Show on plans

3110B

#21

Stepholes shall have a minimum tread of 5 inches and a width of 14 inches.

____ Yes ____ Not Applicable Show on plans

3110B

#22

The safety rail extends from the deck to a point above the top of the lowest step. The upper

surface of the safety rails is located at least 28 inches above the deck.

____ Yes Show on plans

3111B

#23

Handholds will be installed. They will be located not more than 9 inches above water level.

____ Yes ____ Not Applicable Show or note on plans

3111B

#24

Handholds are bullnosed coping or cantilevered decking that is not over 2 ½ inches thick (overhang

shall not exceed 2 inches nor be less than 1 inch).

____ Yes ____ Not Applicable Show or note on plans

PART II OF II (continued)

3111B

#25

This is a special use pool for instruction or competitive swimming which requires a perimeter

overflow lip.

____ Yes ____ No Note on plans

3112B

#26

The diving boards comply with Section 2-9017.

____ Yes ____ Not Applicable Show or note on plans

3113B

#27

A 4 ft. wide or larger deck surrounds pool and rear of diving board, if applicable.

____ Yes ____ Not Applicable Show or note on plans

3113B

#28

The deck is made of concrete or similar material and is slip-resistant and non abrasive.

____ Yes Note on plans

3113B

#29

The deck width separating the pool from any adjacent spa is 6 ft. or greater.

____ Yes ____ Not Applicable Show on plans

3113B

#30

This is a temporary training pool. No deck required.

____ Yes ____ No Show or note on plans

3113B

#31

The deck has a minimum slope of ¼ in. per ft. to deck drains and doesn’t drain into pool.

____ Yes ____ No Show or note on plans

Page 8 of 14

3113B

#32

Drains are not more than 25 ft. apart and do not drain over 400 sq. ft. per drain (4 in. drains). They

drain to _____________________________________________.

____ Yes ____ Not Applicable Show on plans

3115B

#33

Public showers, toilets and dressing rooms will be provided.

____ Yes ____ No Show on plans

3115B

#34

Adjacent living facilities or accommodations are to be used. They are 300 ft. or less away. If so,

Skip #35-38.

____ Yes ____ No Show on plans

3115B

#35

Number of sanitary facilities on basis of 1 bather per 15 sq. ft. of pool surface. The total # of

bathers are ___________.

a. One shower for each 50 bathers provided

b. Separate toilet facilities for men and women on following basis:

women 1T/60; men 1T + 1U/75 men

c. One lavatory for each 80 bathers

3115B

#36

Floors in sanitary facilities hard, non-absorbent extending up wall 5 inches with coved base. They

are slip-resistant and sloped ¼ inch per foot to floor drain.

____ Yes Show or note on plans

3115B

#37

Walls are of material not adversely affected by moisture. Privacy is maintained.

____ Yes Show or note on plans

PART II OF II (continued)

3115B

#38

Showers are supplied with hot and cold potable water. The hot water is limited to 110 degrees F.

maximum.

____ Yes Show & note on plans

3116B

#39

There is 1 drinking fountain for first 250 bathers and 1 for each 200 thereafter (exception: when

drinking water is available in living quarters or clubhouse).

____ Yes Show on plans

3117B

#40

Hose bibb available so that all portions of deck can be reached with 75 ft. hose.

____ Yes Show on plans

3118B

#41

Fencing and gates at least 5 ft. in height enclose pool. No opening greater than 4 inches in any

dimension exists.

____ Yes ____ Not Applicable Show on plans

3118B

#42

Gate is equipped with self-closing and self-latching device located 3 ½ ft. or higher above deck.

Gate opens outwardly.

____ Yes ____ Not Applicable Show or note on plans

3118B

#43

The bottom of the enclosure is within 2 inches of the finished grade.

____ Yes ____ Not Applicable Show on plans

Page 9 of 14

3118B

#44

Any horizontal bars are spaced a minimum of 48 inches apart.

____ Yes Show on plans

3119B

116045

#45

The following signs will be posted in a conspicuous place at the pool and required information

added (circle letter):

a. Occupant Load sign (4 inch letters)

b. Warning-No Lifeguard on Duty sign (4 inch letters)

c. No Diving Allowed sign (depth 6 ft. or less) ( 4 inch letters)

d. Danger: Gaseous Oxidizer-Chlorine sign (4 inch letters)

e. Emergency Phone Number sign

f. Artificial Respiration Procedures sign

____ Yes Show or note on plans

3120B

#46

Pool is located indoors and is ventilated according to Section 605 of the Uniform Building Code.

____ Yes ____ Not Applicable Show or note on plans

3121B

#47

Pool equipment room is mounted on a Portland cement concrete or similar floor material and

sloped ¼ in./ft. to floor drain.

____ Yes ____ No Show or note on plans

3122B

#48

The chlorine gas equipment room complies with Sec. 2-9028:

a. Not located below ground level

b. Entry door does not open onto pool or deck

c. Fresh air intake within 6 inches of ceiling

Page 10 of 14

PART II OF II (continued)

d. Mechanical exhaust produces 60 air changes/hour and vented to outside air discharge

at least 10 ft. from windows or adjacent bldgs.

____ Yes ____ Not Applicable Show & note on plans

3123B

#49

Recirculation system: (Answer a-h)

a. Discharge flow velocity does not exceed 10 ft./second on inlet piping and

8 ft./second on suction pipe

____ Yes Note on plans

b. All filters, valves, pumps, strainers and equipment requiring adjustments are readily

accessible for repair and replacement

____ Yes Note on plans

c. Pressure gauge on influent and effluent lines

____ Yes Show on plans

d. Flowmeter will be supplied

____ Yes Show on plans

e. Vacuum gauge on suction type filters

____ Yes ____ Not Applicable Show on plans

f. Hair and lint strainer is provided on the suction side of the recirculation pump

____ Yes Show on plans

g. Backwash piping and valves to be installed. The backwash will go to

__________________________________

____ Yes ____ Not Applicable Show & note on plans

h. Valves area easily accessible and not located under decking. They are marked for

identification.

____ Yes Note on plans

3126B

#50

The pump capacity is designed at which of the following heads? (please circle the letter)

a. Pressure D.E. – 60 ft. head

b. Vacuum D.F. – 40 ft. head

c. Rapid Sand – 45 ft. head

d. Hi rate sand – 60 ft. head

e. Cartridge filter – min 60 ft. head

3127B

#51

There is a permanently installed refill line to pool, (Spas, temp. pools, and pools less than 1500 gal.

are exempt), with air gaps, vacuum breaker or double check valve.

____ Yes Show & note on plans

3127B

#52

Pool refill inlets not less than 1 inch or less than 2 pipe diameters above overflow rim for air-gap

separation.

____ Yes ____ Not Applicable Note on plans

3127B

#53

Pool refill inlet is protected with a backflow prevention device.

____ Yes ____ Not Applicable Note on plans

3129B

#54

A rapid sand filter is being installed. If filtration rate does not exceed 3 gpm/sq. ft. Backwash is not

less that 12 gpm/sq. ft. of filter area.

____ Yes ____ Not Applicable Show & note on plans

Page 11 of 14

PART II OF II (continued)

3130B

#55

A diatomaceous earth filter is being installed. If filtration rate does not exceed 2 gpm /sq. ft. or 2 ½

gpm for continuous feeding for filter aid for pools 2000 sq. ft. or more.

____ Yes ____ Not Applicable Show & note on plans

3131B

#56

A high rate sand filter is being installed. If filtration rate does not exceed 15 gpm/sq. ft.; its

backwash minimum is 15 gpm.

____ Yes ____ Not Applicable Show & note on plans

3131B

#57

#57A

A cartridge filter is being installed. If filtration rate does not exceed 0.375 gpm/sq. ft.

____ Yes ____ Not Applicable Show & note on plans

Cleaning sink installed. _____Yes

3132B

#58

The chemical feeders comply with Section 3132B.

____ Yes ____ Not Applicable Note on plans

3133B

#59

The disinfectant feeders comply with Section 3133B.

____ Yes ____ Not Applicable Note on plans

3133B

#60

Chlorine gas to be used. Scales provided.

____ Yes ____ Not Applicable Note on plans

3133B

#61

Chlorine gas piping is not located outside equipment room.

____ Yes ____ Not Applicable Show & note on plans

3134B

#62

Skimmers: (surface area less than 5000 sq. ft.) (Answer a-e if applicable)

a. One skimmer for each 500 sq. ft. or fraction thereof is provided and capable of

withdrawing 75% of required recirculation capacity

____ Yes ____ No ____ Not Applicable Show & note on plans

b. Skimmer is built-in type, recessed into pool wall, individually adjustable for rate of flow,

automatically adjusts to variations in pool level within 4 inches, has a removable and cleanable

screen or basket, and is provided with an air lock protective device to prevent air

leakage into recirculation system

____ Yes ____ No ____ Not Applicable Show & note on plans

c. Skimmer located in relation to pool inlets so as to aid recirculation and skimming

____ Yes ____ No ____ Not Applicable Show on plans

d. Skimmer flow rate does not exceed 80 gpm

____ Yes ____ No ____ Not Applicable Note on plans

e. Anti-hair catching equalizer line covers provided

____ Yes ____ No ____ Not Applicable Note on plans

Page 12 of 14

313B4

#63

Perimeter overflow: (surface area over 5000 sq. ft.) (Answer a-h if applicable)

a. Capable of withdrawing 75% of required recirculation capacity

____ Yes ____ No ____ Not Applicable Show & note on plans

b. Overflow channel not less than 3 inches deep and 3 inches wide. The opening

beneath deck into channel minimum of 4 inches

____ Yes ____ No ____ Not Applicable Show & note on plans

c. Channel lip is no greater than 12 inches below top of deck, with rounded lip edge with

maximum thickness of 2 ½ inches for top 2 inches and minimum thickness of 1 inch for

top 2 inches

____ Yes ____ No ____ Not Applicable Show & note on plans

PART II OF II (continued)

d. Channel outlet minimum 2 ½ inches in diameter

____ Yes ____ No ____ Not Applicable Show & note on plans

e. Not more than 15 ft. apart and channel slope to outlets not less than ¼ inch/ft.

____ Yes ____ No ____ Not Applicable Show & note on plans

f. Channel drain shall not be less than 1.5 times area of outlet piping

____ Yes ____ No ____ Not Applicable Note on plans

g. Surge tank storage minimum 1 gals/sq. ft. of surface area:

Size: ______________________________

____ Yes ____ No ____ Not Applicable Show & note on plans

h. Automatic surge flow control to make-up water with manual over ride for maintaining pool

water level provided

____ Yes ____ No ____ Not Applicable Note on plans

3134B &

3108B

#64

Bottom Drains: (Answer a-d)

a. Pool can be drained through two bottom drains. The drain goes to

____ Yes ____ Not Applicable Note on plans

b. They are covered by a protective cover whose opening does not exceed ½ inch in its

smaller dimension

____ Yes Show or note on plans

c. Grates removable only with tools

____ Yes Note on plans

d. Must have 2 main drains with at least 2 feet separation to prevent a suction hazard to

bathers

____ Yes Show on plans

Page 13 of 14

3134B

#65

Inlets: (Answer a-f)

a. Minimum of two inlets for first 10,000 gal. and one inlet for each additional 10,000

gal. or fractional part. There are ______________ inlets

b. Located not less than 18 inches below waterline (spa and wading pools exempt)

____ Yes ____ No Show & note on plans

c. Inlets do not protrude greater than 1 ¼ inch into pool and are rounded or smooth

____ Yes ____ No Note on plans

d. Inlets are separated by at least 10 ft. and are located so as to ensure uniform circulation

____ Yes ____ No Show & note on plans

e. Pools greater than 40 ft. in width: has 1 floor inlet/10,000 gal. or fractional part thereof

____ Yes ____ No ____ Not Applicable Show & note on plans

f. Provisions have been made for adjusting the volume (floor inlets only) and direction of

flow from the wall inlets

____ Yes ____ No Note on plans

3136B

#66

A built-in or portable type vacuum cleaning system has been provided.

____ Yes Note on plans

PART II OF II (continued)

3137B

#67

Waste Disposal: (Answer a-e)

a. The backwash goes to _______________________(septic systems not allowed)

b. If D.E. filter, there is a receiving chamber, e.g. floor sink, which catches waste D.E.

____ Yes ____ Not Applicable Show on plans

c. Sumps and drain piping have sufficient capacity to receive pool system backwash without

overflowing the sump receiver

____ Yes Note on plans

d. A sight glass on waste discharge line from filter provided. Exception: air gap visible to

operator during backwash operation

____ Yes ____ No ____ Not Applicable Show or note on plans

e. There is no direct connection of the pool or its recirculation system with the sanitary

sewer, storm drain or drainage system

___ Yes ____ No Show or note on plans

Page 14 of 14

3-680-6

#68

Electrical Requirements: (Answer a-d)

a. Electrical receptacles are located at least 10 ft. from the inside walls of the pool

____ Yes ____ No Note on plans

b. Electrical receptacles located within 15 ft. of the inside walls are protected by ground-

fault circuit interrupter

____ Yes ____ No Note on plans

c. A receptacle that provides power to permanently installed pool recirculating pump

motor is located between 5 and 10 ft. from the inside wall of a pool or spa but is a single,

locking grounding type.

____ Yes ____ No ____ Not Applicable Note on plans

d. Underwater lighting and area lighting is provided. It meets all electrical provisions of

Article #680 of the National Electrical Code, e.g. GFCI.

____ Yes ____ No Show or note on plans

#69

Gas Chlorination:

a. All of Section 65547, Title 22

____ Yes ____ No ____ Not Applicable Note on plans

b. All of Section 2-9028, Title 24

____ Yes ____ No ____ Not Applicable Note on plans

c. All of Section 2-9041, (c), Title 24

____ Yes ____ No ____ Not Applicable Note on plans

#70

Have provisions for accessibility to the physically handicapped been made.

____ Yes Show or note on plans

_____________________________________ ______________________ _________________

Contractor/Designer Signature License Number Date

_____________________________________ ______________________ _________________

Plans checked by Approved ___ Yes ___ No Date

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

SWIMMING POOL PLAN CHECK SHEET (California)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank SWIMMING POOL PLAN CHECK SHEET (California) Form

Related forms

Fillable SWIMMING POOL PLAN CHECK SHEET (California)

Fill Online, Printable, Fillable, Blank SWIMMING POOL PLAN CHECK SHEET (California) Form

Related forms

First 20 documents completely FREE!