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Oconee County Environmental Health P.O. Box 222, 7635 Macon Hwy., Suite # 180, Watkinsville, GA 30677 Phone# [PHONE REDACTED] – Fax [PHONE REDACTED] APPLICATION FOR SWIMMING POOL, SPA, AND RECREATIONAL WATER PARK OPERATION PERMIT Complete and submit this application to the Oconee County Environmental Health Department 10 business days prior to opening the pool or beginning pool construction. Name of Type of Facility Served Check Appropriate Block(s): Swimming Pool Spa Recreational Water Park New Existing Plans/Blueprints Provided Special Purpose Pool (If checked please check the type pool below.) Activity/Interactive/Wading Pool Continuous Water Course Dual Use Pool Falling-Entry Pool Wading Pool Wave Pool Zero-Depth Entry Pool Zero-Depth Pool Sewage Disposal Public Sewer Individual Septic System Water Supply: Public Water Individual Well Community Well Address of Facility: Street, Highway, or RFD City County Zip Code Physical Location of Facility: (PLAT indicating physical location) Facility Owner’s Name: Phone Number: Facility Owner’s Address: Email: Facility’s Billing Address: Street, Highway, or RFD City County Zip Code State Pool Operator’s Name: CPO* Expiration Date: Please provide copy of CPO Pool Operator’s Email: Pool Operator’s Address Street, Highway, or RFD City County Zip Code State Phone Number Construction Date: Date Operation to Begin: (If Seasonal) Date Operation to Begin: Date Operation to Close: Hours of Operation: Open At To Close At: AM/PM The Type of Disinfectant to be used: Pursuant to the Swimming Pools, Spas and Recreational Water Park Rules and Regulations Chapter 300 as adopted by the Oconee County Board of Health, an application is hereby made for a permit to operate the public swimming pool, spa, recreational water park as described above and the pool owner or authorized agent hereby certifies that he has received a copy of these stated Rules and Regulations. Signed (STATE whether Owner or Authorized Agent for the Owner) Date