"Pool/SPA Daily Log Sheet Template - Health District"

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Pool/Spa Daily Log Sheet
Month _______________, 20_____
Pool Name _____________________________ Type of Pool ______________________
Pool Manager ___________________________ Type of Disinfectant _______________
TEST DAILY
TEST WEEKLY
RECORDS WHEN APPLIED
Day
Time
Init.
Free
Total
Combined
pH
Temp
Flow
Bather
Alk.
Cyan.
Disinfectant/chemicals
Comments
chlorine
chlorine
Chlorine*
(7.2-8.0)
rate
load
acid
And quantity added
(closure, injury, clarity, etc)
*Combined = Total - Free
Environmental Health Division
1101 W. College, Ste. 402
Spokane, WA 99201
324-1560, Ext. 4, TDD 1464
B&W/Water Rec/Pool/spa daily log
Revised 3-2005
Always working for a safer and healthier community
Pool/Spa Daily Log Sheet
Month _______________, 20_____
Pool Name _____________________________ Type of Pool ______________________
Pool Manager ___________________________ Type of Disinfectant _______________
TEST DAILY
TEST WEEKLY
RECORDS WHEN APPLIED
Day
Time
Init.
Free
Total
Combined
pH
Temp
Flow
Bather
Alk.
Cyan.
Disinfectant/chemicals
Comments
chlorine
chlorine
Chlorine*
(7.2-8.0)
rate
load
acid
And quantity added
(closure, injury, clarity, etc)
*Combined = Total - Free
Environmental Health Division
1101 W. College, Ste. 402
Spokane, WA 99201
324-1560, Ext. 4, TDD 1464
B&W/Water Rec/Pool/spa daily log
Revised 3-2005
Always working for a safer and healthier community
TEST DAILY
TEST WEEKLY
RECORDS WHEN APPLIED
Day
Time
Init.
Free
Total
Combined
pH
Temp
Flow
Bather
Alk.
Cyan.
Disinfectant/chemicals
Comments
chlorine
chlorine
Chlorine*
(7.2-8.0)
rate
load
acid
And quantity added
(closure, injury, clarity, etc)
*Combined = Total - Free
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