Pool test Record Sheet

• Audit Title

• Document No.

• Client / Site marquise

• Conducted on

  Date

• Prepared by building manager

• Location
  Address

plant area

• Is the outside of boiler ok

  Yes

  No

  N/A

• Is the boiler working correctly

  Yes

  No

  N/A

• Is there flow

  Yes

  No

  N/A

• Is the surrounding floor from the boiler clear<br>

  Yes

  No

  N/A

• Are all pipes free from leaks

  Yes

  No

  N/A

• Are the pool pumps working 1-4

  Yes

  No

  N/A

• Are all cupboards free from water ingress

  Yes

  No

  N/A

• Cupboard doors

  Yes

  No

  N/A

• Is the walkway clean &dry

  Yes

  No

  N/A

• Is the walkway/exit clear from hazards

  Yes

  No

  N/A

Chemical feeder readings

• ORP meter reading

• PH meter reading

• Is the salt chlorinator working

  Yes

  No

  N/A

• Pool Boiler temp

• Is the boiler working

  Yes

  No

  N/A

• Is the exhaust fan working

  Yes

  No

  N/A

Pool Temperatures

• Manual temp reading

• Outside temp

• Outside conditions

Pool Water Test Readings

• Chlorine free (DPD-XF)

• Chlorine total (DPD-XT)

• Ph value (Phenol Red)

• Alkalinity total (Alkaphot)

Pool Area Inspections

• Pool door

  Safe

  At Risk

  N/A

• Signage

  Safe

  At Risk

  N/A

• Deck area clean

  Safe

  At Risk

  N/A

• Step Lights working

  Yes

  No

  N/A

• Pool wall

  Safe

  At Risk

  N/A

• Pool fence

  Safe

  At Risk

  N/A

• Camera working

  Yes

  No

  N/A

• Media

  Media

• Comments

Action

• Faults rectified from previous audit

  Yes

  No

  N/A

Signatory

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

  Sign