Title Page

  • Site conducted

  • Conducted on

  • Prepared by

Lodges, Pool & Spa

  • Lodge samples taken and Lodge identified on bottle ?

  • Record Lodge No's

  • Pool & Spa samples taken & identified on bottle ?

Date sent

  • Enter date samples collected by Courier

Notes & Sign off

  • Any further actions performed or required ?

  • I confirm data entries are True & Correct and Supervisor has been made aware of any issues that may affect the results of the performed testing.

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