Pool Plant Room Inspection

• Client / Site

• Conducted on

  Date

• Prepared by

Chlorine Dosing System / Emergency Shut Off System

• Dosing Unit (not in alarm, automatic mode)

  Yes

  No

  N/A

• Chlorine injector line (breaks, leaks air trapped in line)

  Safe

  At Risk

  N/A

• Chlorine Cylinders (chained and secured)

  Safe

  At Risk

  N/A

• Fan operational

  Yes

  No

  N/A

• Door latch secured and open

  Yes

  No

  N/A

• Chlorine Dosing Pump Inspection (noise, visual and smell)

  Safe

  At Risk

  N/A

• Air Cylinder Gauge (in range on gauge)

• Check tubing for leaks (mist or hiss)

  Pass

  Fail

  N/A

• Hydra Sentinel Unit System Check (powered, alarms, battery)

  Pass

  Fail

  N/A

• Test Emergency Shut Off System

  Yes

  No

  N/A

Chemical Storage Area

• Dump Shower / Eye Wash Station operational

  Pass

  Fail

  N/A

• PPE available, good condition and appropriately stored (Glasses, boots, apron, glasses, mask, gloves)

  Pass

  Fail

  N/A

• Chemical Spill Kit

  Yes

  No

  N/A

• Chemical Storage (Bunding, sufficient distance)

  Pass

  Fail

  N/A

• Floor tidy (remove trip hazards)

  Yes

  No

  N/A

Chemical Stores

• Cylinder 1 (kg remaining) *If both cylinders below 20kg order should be placed.

• Cylinder 2 (kg remaining)

• Sodium Bicarbonate (20kg)

• Sodium Bisulphate (20kg)

• Rock Alum (20kg)

• Calcium Chloride (20kg)

• Sodium Hypochlorite (10L)

• Hydrochloric Acid (10L)

• Calcium Hypochlorite (10kg)

Filtration System

• Filter 1 (kPa pressure gauge)

• Filter 2 (kPa pressure gauge)

• Filter 3 (kPa pressure gauge)

• Pump Inspection (noise, visual and smell)

  Good

  Fair

  Poor

  N/A

• Balance Tank inspection (levels, outlets)

  Pass

  Fail

  N/A

• Strainer Basket (empty if required)

  Yes

  No

  N/A

Mechanical Systems

• Heating, ventilation and air conditioning (HVAC) systems operating (check heat upstairs)

  Pass

  Fail

  N/A

Electrical Systems

• Switch board inspection (not tripped fuse, exposed wiring etc).

  Safe

  At Risk

  N/A

• Lighting

  Pass

  Fail

  N/A

SI Index

• Ph + TF + CF + AF - TDS = S.I. INDEX

• Yes

  No

  N/A