Spa test Record Sheet

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Spa Test AM

• Spa Test Conducted at:

  Date

Plant area

• Is the boiler working

  Yes

  No

  N/A

• Is there flow

  Yes

  No

  N/A

• Is the out side boiler ok

  Yes

  No

  N/A

• Surrounds of boiler clen

  Yes

  No

  N/A

• Are all pipes free from leaks

  Yes

  No

  N/A

• Is the boiler cupboard free from water ingress

  Yes

  No

  N/A

• Is the pump working

  Yes

  No

  N/A

• Is the pump free from leaks

  Yes

  No

  N/A

• Is the pump cupboard free from water ingress

  Yes

  No

  N/A

• Is the the walkway/exit clean

  Yes

  No

  N/A

• Walk way/ exit hazards

  Safe

  At Risk

  N/A

Spa Temperatures

• Spa boiler temp

• Is the boiler working

  Yes

  No

  N/A

• Manual temp reading

• Outside temp

• Room temp

Spa Water Test Readings

• Bromine (DPD no 1)

• PH value ( Phenol red)

• Alkalinity (Alkaphot)

Spa Area Inspections

• Signage

  Safe

  At Risk

  N/A

• Spa door

  Safe

  At Risk

  N/A

• Is the spa free from hazards

  Safe

  At Risk

  N/A

• Spa walls clean

  Yes

  No

  N/A

• Spa deck clean

  Yes

  No

  N/A

• Shower turned off

  Yes

  No

  N/A

• Shower in working condition

  Yes

  No

  N/A

• Lights working

  Yes

  No

  N/A

• Are the spa jets working

  Yes

  No

  N/A

• Is the room free from condensation<br>

  Yes

  No

  N/A

• Media

  Media

• Comments

Actions taken for hazards

Faults

• Faults rectified from previous audit

  Yes

  No

  N/A

Signatory

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

  Sign