Title Page
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Site conducted
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Conducted on
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Prepared by
Lodges, Pool & Spa
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Lodge samples taken and Lodge identified on bottle ?
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Record Lodge No's
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Pool & Spa samples taken & identified on bottle ?
Date sent
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Enter date samples collected by Courier
Notes & Sign off
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Any further actions performed or required ?
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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.