Title Page

  • Location

  • Prepared by

  • Conducted on

Water Quality

  • Disinfectant- Chlorine must be at least 1.0 ppm for pools <br> *Operator cannot correct by adding granular chlorine must be corrected through chlorinator

  • PH- maintained within 7.2 to 7.8

  • Cyanuric Acid- at or below 50 ppm

  • Water Clarity- pool floor and main drains clearly visible

  • Can you see the screws in the main drain?

  • Clear pool of residents until drains are visible

  • Record Book present

  • Daily entries recording Chlorine, pH and drain checks

  • Weekly records of Cyanuric Acid, Total Alkalinity and general maintenance performed

  • Test Kit present and reagents not expired. Shall be able to test for chlorine, pH, cyanuric acid, total alkalinity, and calcium hardness <br> *Note- Recommended test kit Taylor K-2005.

Drain Covers-Main Drains and Skimmer Equalizer Lines

  • Pool Drain Safety Compliance Form- VGB form up to date

  • Suction Outlets-All expired covers have been replaced with approved covers and compliance forms updated

  • All Drain and Equalizer line covers in place, secure and in good repair

  • Free of protrusions greater than 2" from pool walls

  • If skimmers are plugged, they should be plugged or plastered on the wall and inside the skimmer under the basket

Pool Maintenance

  • Pool Operator- Daily visit and records kept

  • Vacuum fittings- Vacuum ports must have a secured cap or self-closing, self latching cap.

  • Skimmer weirs in place

  • Skimmer baskets in good repair

  • Skimmer lid in good repair with no cracks or damage

  • Pool floors and walls clean and in good repair. *No cut hazards/cracks or exposed mortar?

  • Depth Markers-4" in height and in good repair *Note: Depth markers around the perimeter should be close as possible to the edge.

  • Depth markers located at point of max. and min depth at both ends of the pool and located at the transition point

  • No Diving Markers- 4" in height for letters or red and black international No Diving. <br> *Note- No greater than 25' apart and in good repair and legible

  • Inlets and Fittings -Must be in good repair and in place <br> *Note- Floor inlets must have at least 1/2 of there screws in place

  • Contrasting Color Bands must in good repair with no chipping <br> *Note- 2" wide color band at edge of step or 2"x2" tile no greater than 1" from step edge and pool wall

  • Breakpoint for pools greater than 5' in depth <br> *Note- Safety Rope provided at breakpoint with colored floats no greater than 5' between them and 2" wide color band across the pool bottom

Premises and Safety

Safety Equipment

  • Body hook on a non-collapsible pole a min. of 12' in length and in good repair

  • USCG approved ring buoy present and in good repair with required rope length <br> *Note- Lifeguards with lifeguard tubes may replace ring buoys

Signage

  • Signage must be in good repair and visible upon entrance to the pool

  • "WARNING-NO LIFGUARD ON DUTY" posted on at least 3 sides of pool, facing the pool (P-04) (B)

  • *Using the Pool Policy layout identify the location of missing/damaged signage*

  • WP Pool Rules (P-07 VA)(A) visible and in good condition *Note: except TX

  • *Using the Pool Policy layout identify the location of missing/damaged signage*

  • "NO DIVING-NO RUNNING" (P-10)(C) to have 2 signs mounted on the inside of the fence facing the pool

  • *Using the Pool Policy layout identify the location of missing/damaged signage*

  • "AUTHORIZED PERSONNEL ONLY" mounted on pump room and chemical storage room entrance door (P-03) *Note: except TX

  • *Using the Pool Policy layout identify the location of missing/damaged signage*

  • "Daily Water Quality Reading Board" posted in highly visible location for spa/hot tubs only

Decking

  • Decks slip-resistant

  • No trip hazards present and or free of protrusions or offsets greater than 1/2"

Lighting

  • Underwater light niches shall be maintained or covered so not to present a hazard with no openings greater than 1/2"

Barrier- Gate Requirements

  • Gates shall be at least 48" in height from the ground to top of fence

  • Vertical members 4" or less in width

  • All gates must be self-latching and self closing

  • Gate latches to measure 54" from the ground to bottom of latch

  • If self-latching device is less than 54", the latch shall be located on the inside of the gate at least 3" below the top of the gate with no greater than 1/2" within 18" of the latch mechanism (mesh-1/2"x 1/2" or less required) <br> *Note- NO height requirement for electronic systems

Equipment Room

Chlorinator

  • Chemical Feeders in good working order, free of excessive scaling or build up

  • Liquid feeder shall be verified during inspection. Chlorinator and/or acid feeder shall detect flow of water and turn off when no water flowing through the pump

  • Chlorinator free of visible leaks

  • Replacement feeder hose and seals present

Pump

  • Pump free of visible leaks

  • Pump specs. up to date on VGB form on file

  • Extra basket for pump

Filter and Recirculation

  • Free of large leaks and equipment functioning properly

  • Pressure gauges operating properly and shows pressure readings

  • Cartridge filters shall have additional cartridges available

Flow Meter

  • Operating properly and located on the return line

  • Free of visible leaks

Imminent Hazards

  • No exposed chlorine or chemicals in skimmer

  • No electrical hazards on or near deck

  • No broken glass

  • Additional Comments/Notes

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.