Title Page

  • Site conducted

  • Prepared by

  • Date & time conducted

  • Location (if not in system)

  • Premises Name (if not in system)

  • Name of water body (if facility has more than one)

  • Type of report

Checklist

Water quality

  • Free Chlorine levels

  • The permitted level is:

  • The measured level is:

  • pH levels

  • The permitted level is:

  • The measured level is:

  • Cyanuric acid levels

  • The permitted level is between 20 and 100 milligrams per litre

  • The measured level is:

  • Water temperature

  • The maximum temperature of an aquatic facility is 38 degrees C

  • The measured temperature is:

  • Water clarity

  • Microbiological levels

  • Type of organism detected:

  • The required control strategy is

Facility non-compliance

  • Pool gate latches closed from any point of release

General comments

  • Further comments (if applicable)

  • This information is provided for your attention and urgent rectification.
    It is your responsibility as an aquatic facility operator/manager to ensure the facility complies with all requirements of the Health (Aquatic Facilities) Regulations 2007 and the Code of Practice for the Design, Construction, Operation, Management & Maintenance of Aquatic Facilities. A copy of the Code is available below.

  • Authorised Officer Signature

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