Pool Test Record Sheet

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Pool Test AM

• Pool Test Conducted at:

  Date

Pool Temperatures

• Main Pool Temperature (Degrees Celcius)

• Toddler Pool Temperature (Degrees Celcius)

Chemical Feeder Readings

• ORP

• pH

Pool Water Test Readings

• Free Chlorine

• Total Chlorine

• pH

Pool Area Inspections

• Pool Gate

  Safe

  At Risk

  N/A

• Children's pool blower pump and timer switch

  Safe

  At Risk

  N/A

• Perimeter Fence

  Safe

  At Risk

  N/A

• Pool Rescue Equipment

  Safe

  At Risk

  N/A

Signatory

• I hereby advise that the records above are true and correct.

  Sign

Pool Test PM

• Pool Test Conducted at:

  Date

Pool Temperatures

• Main Pool Temperature (Degrees Celcius)

• Toddler Pool Temperature (Degrees Celcius)

Chemical Feeder Readings

• ORP

• pH

Pool Water Test Readings

• Free Chlorine

• Total Chlorine

• pH

Pool Area Inspections

• Pool Gate

  Safe

  At Risk

  N/A

• Children's pool blower pump and timer switch

  Safe

  At Risk

  N/A

• Perimeter Fence

  Safe

  At Risk

  N/A

• Pool Rescue Equipment

  Safe

  At Risk

  N/A

Signatory

• I hereby advise that the records above are true and correct.

  Sign