"Daily Chemistry Log Sheet" - County of San Diego, California

Daily Chemistry Log Sheet is a legal document that was released by the Department of Environmental Health and Quality - County of San Diego, California - a government authority operating within California. The form may be used strictly within County of San Diego.

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County of San Diego
MONTH:
/ 20
DEPARTMENT OF ENVIRONMENTAL HEALTH AND QUALITY | FOOD AND HOUSING DIVISION
P.O. BOX 129261, SAN DIEGO, CA 92112-9261 | Phone: (858) 505-6900 | Fax: (858) 999-8920 | 1 (800) 253-9933 |
www.sdcdehq.org
Cyanuric Acid:
ppm (Max. 100 ppm)
Daily Chemistry Log Sheet
:
/
/
Date measured
Facility
Facility
Hours of
Permit
Name
Operator
Operation
Number
Facility
Pool
Contact
Volume
Occupancy
 # (
Address
Name
)
(gallons)
D
T
M
& N
A I L Y
E S T S
AINTENANCE
OTES
Safety Checklist Completed on:
/
/20
Sanitizer Concentration (ppm)
Pressure
Date
Main Drain
REMARKS: Equipment repaired, water added, clarity, fecal accident, backwash, clean,
Water
-
Gauges
fencing/gate repaired, quantity/type of chemicals added, etc.
pH
Cover
Free
Combined Cl
Temp.
(backwash if
Example:
Backwashed pool filter, added more water, repaired pool gate, etc.
In good repair?
Initial/Adjusted
(7.2 - 7.8)
TC-FC=CC
difference is >10 psi)
(°F)
Close the pool if the main drain cover is loose, missing, or broken.
Initial
Adjusted
TC
CC
YES
NO
Influent Effluent
1
2
3
4
5
6
7
8
9
10
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County of San Diego
MONTH:
/ 20
DEPARTMENT OF ENVIRONMENTAL HEALTH AND QUALITY | FOOD AND HOUSING DIVISION
P.O. BOX 129261, SAN DIEGO, CA 92112-9261 | Phone: (858) 505-6900 | Fax: (858) 999-8920 | 1 (800) 253-9933 |
www.sdcdehq.org
Cyanuric Acid:
ppm (Max. 100 ppm)
Daily Chemistry Log Sheet
:
/
/
Date measured
Facility
Facility
Hours of
Permit
Name
Operator
Operation
Number
Facility
Pool
Contact
Volume
Occupancy
 # (
Address
Name
)
(gallons)
D
T
M
& N
A I L Y
E S T S
AINTENANCE
OTES
Safety Checklist Completed on:
/
/20
Sanitizer Concentration (ppm)
Pressure
Date
Main Drain
REMARKS: Equipment repaired, water added, clarity, fecal accident, backwash, clean,
Water
-
Gauges
fencing/gate repaired, quantity/type of chemicals added, etc.
pH
Cover
Free
Combined Cl
Temp.
(backwash if
Example:
Backwashed pool filter, added more water, repaired pool gate, etc.
In good repair?
Initial/Adjusted
(7.2 - 7.8)
TC-FC=CC
difference is >10 psi)
(°F)
Close the pool if the main drain cover is loose, missing, or broken.
Initial
Adjusted
TC
CC
YES
NO
Influent Effluent
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Daily Pool Check
Check and record pool chemistry daily
Test free chlorine and pH levels at least once per day
Record the readings in the log on the reverse side of this sheet.
A DPD pool kit must be used to measure free chlorine concentrations.
Free residual chlorine levels:
Pool (without Cyanuric Acid) = 1.0 – 10.0 ppm
Pool (with Cyanuric Acid) = 2.0 – 10.0 ppm
Spa, Wader, and Spray Ground = 3.0 – 10.0 ppm
Maintain a pH of 7.2 – 7.8
A pH lower than 7.2 will cause irritation of eyes and skin to the bathers and
etch the pool surface and equipment.
A pH higher than 7.8 will result in a decreased effectiveness of the free
chlorine.
Other important chemical information
Recommended total alkalinity is 80-120 ppm.
Cyanuric acid maximum allowable concentration is 100 ppm.
Combined chlorine (CC) maximum concentration is 0.4 ppm for pools, spa,
waders and spray grounds.
If CC is higher than 0.4 ppm, use breakpoint chlorination (BPC) to release
any bound chlorine compounds (chloramines) that may cause skin, eye and
mucous membrane irritation.
BPC= Add free chlorine at a concentration that is 10 times the CC
concentration to the water to reduce the amount of CC.
IMPORTANT REMINDER
If the sanitizer concentration is not at the approved ranges
or if an immediate health hazard exists,
until the issue has been corrected!
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