Type Full Name :
Sign With Hand
Organization Name
Application Type
Property Manager
State
Close Date
Flow Rate (gal/min)
Wading Pool
City
Owner Type
Certification
Required Attachments
Date of Last Sample
Who is the primary contact person for this facility. e.g. the property owner, a project supervisor or site foreman
Address
Depth (ft)
Applicant Phone #
Volume (gal)
Name
Pool Information
Other
The fee for this application is:
State
Spray Park
Business Owner Details
Email
Application Fee
Facility Phone #
Facility Features
Name
Facility Name
Width (ft)
Name
Trained Pool Operator
Certified Laboratory
Address 2
ZIP
Phone #
Length (ft)
Phone #
Signature
ZIP
Specify Address where the pool is located.
Email
Open Date
Surface Area (sq ft)
ZIP
Applicant Name

The undersigned agrees to comply with all local, county, state and federal orders and regulations applicable to this license, and is responsible for obtaining any and all additional required approvals, permits, and licenses.

  • Licenses are valid for one year from April 1 through March 31.
  • Licenses are not transferable to new owners or new locations.
City
Facility Email
Email
Public Recreational Bathing Facility License Application
Corporation or LLC Officer Information
Phone Number
Pool
Turnover Rate (hrs)
Phone #

Written proof of the following must be submitted prior to the facility being allowed to open to the public:

  • “Trained Pool Operator” certification of a current staff member
  • Annual electrical inspection - passing
  • Bonding/grounding inspection (every 5 years or more often as necessary) - passing
  • Water sample result from NJDEP-certified lab – meets microbiological water quality standards of N.J.A.C. 8:26
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Facility Address
Address
Is the facility a non-profit or government-run?
Facility Information
Hot Tub/Spa
Other Facility Type
City
State
Operating Year Round or Seasonally
Emergency Contact Information
Special Exempt