Orange City Council - Public Pool/Spa Assessment Report

• Public Pool/Spa Assessment Report

• Business Name

• Conducted on

  Date

Business Details

• Proprietor/Company

• ABN/ACN

• Email Address

• Postal Address

• Contact Number

• Person Interviewed

• Inspection Type

  Select Routine Complaint Reinspection

  • Routine
  • Complaint
  • Reinspection

General Information

• Number of Outdoor Pools

  Select 1 2 3

  • 1
  • 2
  • 3

• Number of Indoor Pools

  Select 1 2 3

  • 1
  • 2
  • 3

• Number of Spas

  Select 1 2 3

  • 1
  • 2
  • 3

• Heterotrophic Plate Testing?

  Yes

  No

  N/A

• UV Treatment?

  Yes

  No

  N/A

• Are procedures up-to-date and readily available?

  Yes

  No

  N/A

• Amenities in a clean and sanitary condition?

  Yes

  No

  N/A

Testing Criteria

POOL 1

• Name

• Time of Testing

  Date

• Estimated Bather Load

  Select 0 - 10 10 - 20 20 - 30 30 - 40 40 +

  • 0 - 10
  • 10 - 20
  • 20 - 30
  • 30 - 40
  • 40 +

• Observations: Notes - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.

• Add media

  Media

• Water Temperature

• Free Chlorine: Indoor MIN 2.0mg/L, Outdoor MIN 1mg/L, Cyanuric MIN 3mg/L. +1 where pH >7.6.

• Re-Test Required?

  Yes

  No

  N/A

• Free Chlorine Re-Test

• Total Chlorine: MAX 10mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Total Chlorine Re-Test

• Combined Chlorine - MAX 1mg/L

• pH: MIN 7.0, MAX 7.8.

• Re-Test Required?

  Yes

  No

  N/A

• pH Re-Test

• Total Alkalinity: MIN 80mg/L, MAX 200mg/L

• Calcium Hardness

• Bromine (Spas if applicable): MIN 4.5mg/L, MAX 9mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Bromine Re-Test

• Cyanuric Acid: MAX 50mg/L

POOL 2

• Name

• Time of Testing

  Date

• Estimated Bather Load

  Select 0 - 10 10 - 20 20 - 30 30 - 40 40 +

  • 0 - 10
  • 10 - 20
  • 20 - 30
  • 30 - 40
  • 40 +

• Observations - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.

• Add media

  Media

• Water Temperature

• Free Chlorine: Indoor MIN 2.0mg/L, Outdoor MIN 1mg/L, Cyanuric MIN 3mg/L. +1 where pH >7.6.

• Re-Test Required?

  Yes

  No

  N/A

• Free Chlorine Re-Test

• Total Chlorine: MAX 10mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Total Chlorine Re-Test

• Combined Chlorine - MAX 1mg/L

• pH: MIN 7.0, MAX 7.8.

• Re-Test Required?

  Yes

  No

  N/A

• pH Re-Test

• Total Alkalinity: MIN 80mg/L, MAX 200mg/L

• Calcium Hardness

• Bromine (Spas if applicable): MIN 4.5mg/L, MAX 9mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Bromine Re-Test

• Cyanuric Acid: MAX 50mg/L

POOL 3

• Name

• Time of Testing

  Date

• Estimated Bather Load

  Select 0 - 10 10 - 20 20 - 30 30 - 40 40 +

  • 0 - 10
  • 10 - 20
  • 20 - 30
  • 30 - 40
  • 40 +

• Observations - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.

• Add media

  Media

• Water Temperature

• Free Chlorine: Indoor MIN 2.0mg/L, Outdoor MIN 1mg/L, Cyanuric MIN 3mg/L. +1 where pH >7.6.

• Re-Test Required?

  Yes

  No

  N/A

• Free Chlorine Re-Test

• Total Chlorine: MAX 10mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Total Chlorine Re-Test

• Combined Chlorine - MAX 1mg/L

• pH: MIN 7.0, MAX 7.8.

• Re-Test Required?

  Yes

  No

  N/A

• pH Re-Test

• Total Alkalinity: MIN 80mg/L, MAX 200mg/L

• Calcium Hardness

• Bromine (Spas if applicable): MIN 4.5mg/L, MAX 9mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Bromine Re-Test

• Cyanuric Acid: MAX 50mg/L

POOL 4

• Name

• Time of Testing

  Date

• Estimated Bather Load

  Select 0 - 10 10 - 20 20 - 30 30 - 40 40 +

  • 0 - 10
  • 10 - 20
  • 20 - 30
  • 30 - 40
  • 40 +

• Observations - Odour, Clarity, Colour, Cleaning of Surrounds/Wastewater Drainage.

• Add media

  Media

• Water Temperature

• Free Chlorine: Indoor MIN 2.0mg/L, Outdoor MIN 1mg/L, Cyanuric MIN 3mg/L. +1 where pH >7.6.

• Re-Test Required?

  Yes

  No

  N/A

• Free Chlorine Re-Test

• Total Chlorine: MAX 10mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Total Chlorine Re-Test

• Combined Chlorine - MAX 1mg/L

• pH: MIN 7.0, MAX 7.8.

• Re-Test Required?

  Yes

  No

  N/A

• pH Re-Test

• Total Alkalinity: MIN 80mg/L, MAX 200mg/L

• Calcium Hardness

• Bromine (Spas if applicable): MIN 4.5mg/L, MAX 9mg/L

• Re-Test Required?

  Yes

  No

  N/A

• Bromine Re-Test

• Cyanuric Acid: MAX 50mg/L

Notes & Signatures

• General Notes

• Add media

  Media

• Officer Name

  Select Lindsay Hall Alicia Peters Greg Perry Donna Sims

  • Lindsay Hall
  • Alicia Peters
  • Greg Perry
  • Donna Sims

• Officer's Signature

  Sign

• Owner/Manager Name

• Owner/Manager Signature

  Sign