Title Page

  • Conducted on:

  • Conducted by:

  • Select "Swimming Pool" from UNIT NUMBER

Pool

LOG

  • Doser Indicated pH Value

  • Doser Indicated Cl2 Value (mg/l)

  • Doser Indicated Temp (C)

  • Pool Water Level

  • Has Supervisor been informed of Low Level ?

  • Pool Room Indicated Air Temperature (C)

  • Has Supervisor been informed of Room Temperature ?

  • • Pool Actual Water Temperature (C)

  • Has Supervisor been informed of Pool Temperature ?

  • • Pool Water Clarity

  • Has Supervisor been informed ?

  • Has Supervisor been informed of Clarity ?

  • Obtain water sample from Pool

  • Is sample FREE Chlorine Level between 1.0 & 3.0 ?

  • Has Supervisor been informed of value ?

  • Record sample TOTAL Chlorine level

  • Record sample COMBINED Chlorine Level

  • Has Supervisor been informed of value ?

  • • Is pH between 7.2 and 7.8 ?

  • Has Supervisor been informed of value ?

  • Is Indicated/Actual Cl2 differential greater than 0.3 ?

  • Has Supervisor been informed of value ?

  • Has Reception been informed of Pool Temperature & recorded on signing-in book ?

  • Have all Indicated & actual results been recorded on dated/initialled Test Sheet ?

Notes and Sign Off

  • Any further remedial actions performed or required ?

Sign Off

  • I confirm data entries are True & Correct and Supervisor has been made aware of any issues that may affect the safe operation of the Pool

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.