"Pool Daily Log Sheet" - City of Bloomington, Minnesota

Pool Daily Log Sheet is a legal document that was released by the Environmental Health Division - City of Bloomington, Minnesota - a government authority operating within Minnesota. The form may be used strictly within City of Bloomington.

Form Details:

  • Released on March 1, 2015;
  • The latest edition currently provided by the Environmental Health Division - City of Bloomington, Minnesota;
  • Ready to use and print;
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  • Fill out the form in our online filing application.

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Pool Daily Log Sheet
Pool type
Pool name
Swim
Spa
Wading
Zero-depth
Plunge
Therapy
Month
Year
Size of pool (Gallons)
Daily tests
Other tests
Maintenance
Comments
Date Free Cl 2
Total
Comb.
pH
Temp.
Flow
Main suction outlet
Alk.
CYA
Back
Press.
Other
Manual chem feed, breakdowns, injuries,
0.5 - 5.0
Cl 2
Cl 2
7.2 -
Max. 104°
rate
Close pool if loose,
>50 ppm
<100 ppm
wash
PSI
(e.g. H 2 0 added)
accidents, CPO’s initials
ppm
<0.5 ppm
8.0
GPM
missing or broken. Initial.
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
Community Development
Environmental Health
PH
952-563-8934
BloomingtonMN.gov
1800 W. Old Shakopee Road
FAX
952-563-8949
57_002 (03/15) pg 1 of 1
Bloomington MN 55431-3027
TTY
952-563-8740
Pool Daily Log Sheet
Pool type
Pool name
Swim
Spa
Wading
Zero-depth
Plunge
Therapy
Month
Year
Size of pool (Gallons)
Daily tests
Other tests
Maintenance
Comments
Date Free Cl 2
Total
Comb.
pH
Temp.
Flow
Main suction outlet
Alk.
CYA
Back
Press.
Other
Manual chem feed, breakdowns, injuries,
0.5 - 5.0
Cl 2
Cl 2
7.2 -
Max. 104°
rate
Close pool if loose,
>50 ppm
<100 ppm
wash
PSI
(e.g. H 2 0 added)
accidents, CPO’s initials
ppm
<0.5 ppm
8.0
GPM
missing or broken. Initial.
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
Community Development
Environmental Health
PH
952-563-8934
BloomingtonMN.gov
1800 W. Old Shakopee Road
FAX
952-563-8949
57_002 (03/15) pg 1 of 1
Bloomington MN 55431-3027
TTY
952-563-8740