City of Canada Bay Swimming Pool Inspection Report

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Risk assessment

• Required Personal Protective Equipment (PPE) for this activity is available and will be used

  Yes

  No

  N/A

• NOTE: Do not undertake activity if the required PPE is not available for use - Discuss with your supervisor.

• Risk assessment fronts type of activity has been read and understood.

  Yes

  No

  N/A

• Are there any specific risks identified with the property? If at risk, what action will be taken to eliminate or control the issue?

  Safe

  At Risk

  N/A

• NOTE: If the risk cannot be eliminated/controlled and/or is unsafe, DO NOT undertake the activity - Discuss with your supervisor.
  If during the activity risks are identified and it is unsafe to continue, abandon the activity - Discuss with your supervisor.

• Trading name

• Owner/Proprietor

• Person interviewed

• ABN

• Phone

• Email

• Emergency contamination plan

  Yes

  No

  N/A

• Frequency of superchlorination

• Frequency of filter backwash

Pool information

Pool 1

• Pool type

• Disinfectant used

  Chlorine

  Bromine

• Location

  Indoor

  Outdoor

• Bathing load (previous hour)

  Low (<20)

  Med (20-50)

  High (>50)

• Temperature °C

• Log book maintained and current

  Yes

  No

  N/A

• Dosing

  Select Continuous Automated Non-automated

  • Continuous
  • Automated
  • Non-automated

• Pool clarity

  Clear

  Murky

• Bromine (if used) (mg/L)

• Free Cl2 (mg/L)

• Total Cl2 (mg/L)

• Combined Cl2 (mg/L)

• pH

• Alkalinity (mg/L as CaCO3)

• Comments

• Add media

  Media

• Select date

  Date

Pool 2

• Pool type

• Disinfectant used

  Chlorine

  Bromine

• Location

  Indoor

  Outdoor

• Bathing load (previous hour)

  Low (<20)

  Med (20-50)

  High (>50)

• Temperature °C

• Log book maintained and current

  Yes

  No

  N/A

• Dosing

  Select Continuous Automated Non-automated

  • Continuous
  • Automated
  • Non-automated

• Pool clarity

  Clear

  Murky

• Bromine (if used) (mg/L)

• Free Cl2 (mg/L)

• Total Cl2 (mg/L)

• Combined Cl2 (mg/L)

• pH

• Alkalinity (mg/L as CaCO3)

• Cyanurate (if used) (mg/L)

• Comments

• Add media

  Media

• Select date

  Date

Pool 3

• Pool type

• Disinfectant used

  Chlorine

  Bromine

• Location

  Indoor

  Outdoor

• Bathing load (previous hour)

  Low (<20)

  Med (20-50)

  High (>50)

• Temperature °C

• Log book maintained and current

  Yes

  No

  N/A

• Dosing

  Select Continuous Automated Non-automated

  • Continuous
  • Automated
  • Non-automated

• Pool clarity

  Clear

  Murky

• Bromine (if used) (mg/L)

• Free Cl2 (mg/L)

• Total Cl2 (mg/L)

• Combined Cl2 (mg/L)

• pH

• Alkalinity (mg/L as CaCO3)

• Cyanurate (if used) (mg/L)

• Comments

• Add media

  Media

• Select date

  Date

Premises inspection

• Pool surrounds

• Amenities

• Chemical storage

Inspection results

• General comments

• Add media

  Media

• Inspection rating

  Satisfactory

  Unsatisfactory

• Further action required

  Nil

  Warning letter

  Improvement order

  Prohibition notice

• Reinspection required

  Yes

  No

• Documents to be submitted to Council

Council details

• Name of officer

  Megan Davenport

  Nerisha James

  Charlee Law

• Phone: (02) 9911 6555 Fax: (02) 9911 6550 Email: council@canadabay.nsw.gov.au