State Form 43038 PDF Details

When embarking on a project that includes a swimming pool, spa, or similar aquatic facility in the state of Indiana, familiarization with the State Form 43038, known as the "POOL DATA SHEET," is crucial. This detailed document, an integral part of ensuring compliance with the Indiana Department of Fire and Building Services' regulations, needs to be completed and submitted alongside the "Application For Construction Design Release" (State Form 37318). Its comprehensive structure collects vital project information, including the name, address, and intended use of the facility, be it public access or restricted to specific groups. Design criteria specifics such as pool surface area, volume, deck area, and the required turnover time are meticulously documented to ensure both safety and efficiency are up to standard. Additionally, the form delves into technical specifications of the pool's pump and recirculation systems, disinfection methods, piping, and even layout details like diving boards and safety equipment. Essentially, this form acts as an essential blueprint, ensuring that all aspects of the pool's design, construction, and operational safety mechanisms meet the rigorous standards set forth by state regulations. The inclusion of supporting technical literature for pumps and filters underlines the emphasis on precision and accountability throughout the planning and approval process. By fulfilling the requirements detailed in State Form 43038, project managers and developers can navigate the regulatory landscape more smoothly, paving the way for safer and more enjoyable aquatic facilities.

QuestionAnswer
Form NameState Form 43038
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesswimpoolapp form 43038

Form Preview Example

POOL DATA SHEET

State Form 43038 (R / 6-96)

Return to:

INDIANA DEPARTMENT OF FIRE AND BUILDING SERVICES

PLAN REVIEW DIVISION

OFFICE OF THE STATE BUILDING COMMISSIONER

402 WEST WASHINGTON STREET, RM E245

INDIANAPOLIS, IN 46204

NOTE: This form is to be completed by the submitter.

This form is supplemental to the "Application For Construction Design Release" (State Form 37318).

PROJECT INFORMATION

Name of project

SBC project number

Street address

City

County

Facility use

Spa Spa Pool

 

 

Public swimming pool:

 

 

 

 

 

Wading Pool

Class A

Class B

Class C

Class

Indoor

Outdoor

Pool type

Other (specify): D

DESIGN CRITERIA

Pool surface area (sf)

Pool volume (gal.)

Pool volume (cu. ft.)

 

 

 

 

Deck surface area (sf)

Required turnover time (hrs.)

 

Required GPM

 

 

 

 

Total surface area (sf)

Actual turnover time (hrs.)

 

 

 

 

 

 

 

PUMP AND RECIRCULATION SYSTEM

 

Backwash pump (make and model number)

 

Recirculation pump (make and model number)

 

 

 

 

Total dynamic head (ft.)

 

Total dynamic head (ft.)

 

 

 

 

 

Pump capacity (gpm)

 

Pump capacity (gpm)

 

 

 

 

 

Listing agency backwash pump

 

Listing agency recirculating pump

 

 

 

 

 

 

 

 

 

Filter (make and model number)

 

High Rate Sand

Hair / Lint Catcher

 

 

 

 

Rapid Sand

Pressure

Number of filters or elements

 

Cartridge

Vacuum

 

 

 

 

Diatomite

 

Surface area per filter or element (sf)

 

Rate of filtration (gpm / sf)

Rate of backwash (gpm / sf)

 

 

 

 

Total area of filters (sf)

Area of filter required

Listing agency filter

 

 

 

 

 

 

 

 

 

ATTACH TECHNICAL LITERATURE FOR PUMP(S)

ATTACH TECHNICAL LITERATURE FOR FILTER(S)

 

 

 

 

Page 1 of 2

POOL DATA SHEET (Continued)

State Form 43038 (R / 6-96)

To be completed by submitter.

FOR OFFICE USE ONLY

SBC project number

GAUGES

DISINFECTION

Pressure

Range (GPM)

 

Flowmeter pipe size

Hypochlorite

Cl2 Gas

Vacuum

 

 

 

Bromine

Other

 

 

 

 

 

 

FEEDERS

Make and model number

 

Chemical

 

Slurry

 

 

Make and model number

 

Make and model number

Maximum dosing rate (PPM)

Minimum dosing rate (PPM)

 

 

 

 

 

 

Capacity

Capacity

Injection point

INLETS

MAIN OUTLET

Directional

Adjustable

Floor

Grate opening area required (sq. in.)

Grate opening area provided (sq. in.)

Total number of inlets:

 

 

 

 

 

 

 

 

 

Maximum GPM per inlet

Actual GPM per inlet

 

Velocity through grate (FPS)

Hydrostatic Relief Valve

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

Maximum discharge piping velocity (FPS)

Pipe discharge size (in. dia.)

 

Drain pipe area (sq. in.)

Pipe size (inches, diameter)

 

 

 

 

 

OVERFLOW

 

Flow through main drain (GPM):

 

 

 

 

 

 

Gutters

Skimmers

 

MAKE-UP WATER

Make and model number

 

 

 

 

 

 

 

Public

Private

 

 

 

 

 

Flow through (gutters) (skimmers) (percent)

 

 

Size of fill spout

Location

 

 

 

 

 

Equalizer line (gutters) (in. dia.)

Automatic

Manual

 

 

Listing agency (gutters) (skimmers)

 

Airgap

Backflow Prevention

PIPING

HEATING

Materials

ASTM number(s)

Electric

Solar

Natural Gas

Other

Make and model number

BTU / Hr.

Schedule number

Capacity and location

Maximum water temperature ( F)

Sump pit with air gap for backwash and draining of the pool (wastewater). Project in compliance with Article 680, Indiana Electric Code (675 IAC 17)

MISCELLANEOUS

Diving Boards, Platforms

Fence, Lockable Gate(s)

Lifeguard Chair(s)

Gas Mask

Lifeguards

DPD Test Kit

Ground Fault Interrupter Ladders

Reach Pole (12 feet minimum) Ring Buoy

Telephone (within 300 feet)

Underwater Lighting

Area Lighting

Safety Rope

First Aid Kit

Spine Board

COMMENTS

Page 2 of 2

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1. The State Form 43038 usually requires particular information to be typed in. Ensure that the next fields are filled out:

Stage number 1 for filling in State Form 43038

2. Once your current task is complete, take the next step – fill out all of these fields - Total dynamic head ft, Pump capacity gpm, Total dynamic head ft, Pump capacity gpm, Listing agency backwash pump, Listing agency recirculating pump, Filter make and model number, Number of filters or elements, High Rate Sand Rapid Sand, Hair Lint Catcher Pressure Vacuum, Surface area per filter or element, Rate of filtration gpm sf, Rate of backwash gpm sf, Total area of filters sf, and Area of filter required with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Area of filter required, Listing agency backwash pump, and Rate of filtration gpm  sf inside State Form 43038

Be very attentive when filling in Area of filter required and Listing agency backwash pump, because this is where most users make a few mistakes.

3. Completing GAUGES, Range GPM, Flowmeter pipe size, Pressure Vacuum, Chemical, Make and model number, Slurry, Make and model number, FEEDERS, Hypochlorite Bromine, Make and model number, DISINFECTION, Cl Gas Other, Maximum dosing rate PPM, and Minimum dosing rate PPM is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Make and model number, Maximum dosing rate PPM, and DISINFECTION of State Form 43038

4. Filling in Backflow Prevention, HEATING, Solar Other, Airgap, Electric Natural Gas, Make and model number, BTU Hr, Capacity and location, Maximum water temperature F, Listing agency gutters skimmers, PIPING, Materials, ASTM numbers, Schedule number, and Sump pit with air gap for backwash is key in the next step - you'll want to be patient and fill out every single field!

State Form 43038 conclusion process described (portion 4)

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