Title Page
-
Business Name
-
Conducted on
Business Details
-
Proprietor/Company
-
ABN/ACN
-
Email Address
-
Postal Address
-
Contact Number
-
Person Interviewed
-
Inspection Type
- Routine
- Complaint
- Reinspection
General Information
-
Number of Outdoor Pools
- 0
- 1
- 2
- 3
-
Number of Indoor Pools
- 0
- 1
- 2
- 3
-
Number of Spas
- 0
- 1
- 2
- 3
-
Is Heterotrophic Plate Testing occuring?
-
Please note that heterotrophic plate testing is not a requirement
-
Is UV Treatment in use?
-
Please note that UV Treatment is not a requirement
-
Facilities in a clean and sanitary condition, including bathrooms/change rooms?
Water Quality Criteria
POOL 1
-
Name (e.g. "Outdoor Pool 1" or "25m")
-
Time of Testing
-
Estimated Bather Load
- 0 - 10
- 10 - 20
- 20 - 30
- 30 - 40
- 40 +
-
Observations: Notes - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.
-
Add media
-
Water Temperature (MAX 38)
-
Disinfection: Type of Pool?
-
Free Chlorine: Minimum of 2.0mg/L. If pH is above 7.6, minimum is increased to 3.0mg/L. Cyanuric Acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Free Chlorine: Minimum of 1.0mg/L. If Cyanuric Acid is in use, minimum is increased to 3.0mg/L. If pH is above 7.6, minimum is increased by a further 1.0mg/L.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Is the Spa treated with Chlorine or Bromine?
-
Free Chlorine: minimum is 3.0mg/L. If the pH is above 7.6, minimum is increased to 4.0mg/L. Cyanuric acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Bromine: minimum is 4.5mg/L and maximum of 9.0mg/L.
-
Re-test required?
-
Bromine re-test
-
pH: chlorine pools between 7.0 and 7.8, bromine pools between 7.0 and 8.0.
-
Cyanuric Acid: Maximum 50mg/L. Must only be used in outdoor, chlorine pools.
-
Total Alkalinity: minimum 80mg/L, Maximum 200mg/L
-
Calcium Hardness: ideally between 200 and 400mg/L.
POOL 2
-
Name (e.g. "Outdoor Pool 1" or "25m")
-
Time of Testing
-
Estimated Bather Load
- 0 - 10
- 10 - 20
- 20 - 30
- 30 - 40
- 40 +
-
Observations: Notes - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.
-
Add media
-
Water Temperature (MAX 38)
-
Disinfection: Type of Pool?
-
Free Chlorine: Minimum of 2.0mg/L. If pH is above 7.6, minimum is increased to 3.0mg/L. Cyanuric Acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Free Chlorine: Minimum of 1.0mg/L. If Cyanuric Acid is in use, minimum is increased to 3.0mg/L. If pH is above 7.6, minimum is increased by a further 1.0mg/L.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Is the Spa treated with Chlorine or Bromine?
-
Free Chlorine: minimum is 3.0mg/L. If the pH is above 7.6, minimum is increased to 4.0mg/L. Cyanuric acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Bromine: minimum is 4.5mg/L and maximum of 9.0mg/L.
-
Re-test required?
-
Bromine re-test
-
pH: chlorine pools between 7.0 and 7.8, bromine pools between 7.0 and 8.0.
-
Cyanuric Acid: Maximum 50mg/L. Must only be used in outdoor, chlorine pools.
-
Total Alkalinity: minimum 80mg/L, Maximum 200mg/L
-
Calcium Hardness: ideally between 200 and 400mg/L.
POOL 3
-
Name (e.g. "Outdoor Pool 1" or "25m")
-
Time of Testing
-
Estimated Bather Load
- 0 - 10
- 10 - 20
- 20 - 30
- 30 - 40
- 40 +
-
Observations: Notes - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.
-
Add media
-
Water Temperature (MAX 38)
-
Disinfection: Type of Pool?
-
Free Chlorine: Minimum of 2.0mg/L. If pH is above 7.6, minimum is increased to 3.0mg/L. Cyanuric Acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Free Chlorine: Minimum of 1.0mg/L. If Cyanuric Acid is in use, minimum is increased to 3.0mg/L. If pH is above 7.6, minimum is increased by a further 1.0mg/L.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Is the Spa treated with Chlorine or Bromine?
-
Free Chlorine: minimum is 3.0mg/L. If the pH is above 7.6, minimum is increased to 4.0mg/L. Cyanuric acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Bromine: minimum is 4.5mg/L and maximum of 9.0mg/L.
-
Re-test required?
-
Bromine re-test
-
pH: chlorine pools between 7.0 and 7.8, bromine pools between 7.0 and 8.0.
-
Cyanuric Acid: Maximum 50mg/L. Must only be used in outdoor, chlorine pools.
-
Total Alkalinity: minimum 80mg/L, Maximum 200mg/L
-
Calcium Hardness: ideally between 200 and 400mg/L.
POOL 4
-
Name (e.g. "Outdoor Pool 1" or "25m")
-
Time of Testing
-
Estimated Bather Load
- 0 - 10
- 10 - 20
- 20 - 30
- 30 - 40
- 40 +
-
Observations: Notes - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.
-
Add media
-
Water Temperature (MAX 38)
-
Disinfection: Type of Pool?
-
Free Chlorine: Minimum of 2.0mg/L. If pH is above 7.6, minimum is increased to 3.0mg/L. Cyanuric Acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Free Chlorine: Minimum of 1.0mg/L. If Cyanuric Acid is in use, minimum is increased to 3.0mg/L. If pH is above 7.6, minimum is increased by a further 1.0mg/L.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Is the Spa treated with Chlorine or Bromine?
-
Free Chlorine: minimum is 3.0mg/L. If the pH is above 7.6, minimum is increased to 4.0mg/L. Cyanuric acid should not be in use.
-
Re-test required?
-
Free Chlorine re-test
-
Total Chlorine: maximum is 10.0mg/L.
-
Re-test required?
-
Total Chlorine re-test
-
Combined Chlorine (Total chlorine minus free chlorine): maximum of 1.0mg/L.
-
Bromine: minimum is 4.5mg/L and maximum of 9.0mg/L.
-
Re-test required?
-
Bromine re-test
-
pH: chlorine pools between 7.0 and 7.8, bromine pools between 7.0 and 8.0.
-
Cyanuric Acid: Maximum 50mg/L. Must only be used in outdoor, chlorine pools.
-
Total Alkalinity: minimum 80mg/L, Maximum 200mg/L
-
Calcium Hardness: ideally between 200 and 400mg/L.
Record Requirements
-
What kind of disinfection dosing systems are in use?
- Continuous Metered Disinfection Dosing System
- Automatic Dosing System
-
Manual testing of disinfectant level and pH is required once per day, prior to pool opening. Records up to date?
-
Manual testing of disinfectant level and pH is required once per day. Records up to date?
-
System indicated levels of disinfectant and pH must be recorded once per day prior to the pool opening, and a second time during operation. Records up to date?
-
Is the disinfectant in use liquid chlorine (sodium hypochlorite), and/or is a carbon dioxide-based pH control in use?
-
Total alkalinity must be tested and recorded once per month. Records up to date?
-
Total alkalinity must be tested and recorded once per day. Records up to date?
-
Are incident response procedures easily accessible and up-to-date? Includes faecal and vomiting.
Notes & Signatures
-
General Notes
-
Add media
-
Officer Name
- Greg Perry
- Lyndal Gray
- Lily Escreet
-
Officer's Signature
-
Owner/Manager Name
-
Owner/Manager Signature