Water Contamination Response Log

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WATER CONTAMINATION RESPONSE LOG
Person Conducting Contamination Response
Supervisor on Duty
Date (mm/dd/yyyy) of Incident Response
Time of Incident Response
Water Feature or Area Contaminated
Number of People in Water
Type/Form of Contamination in Water:
Fecal Accident (Formed Stool or Diarrhea), Vomit, Blood
Time that Water Feature was Closed
Stabilizer Used in Water Feature (Yes/No)
Water Quality Measurements
Level at
1
2
3
Level Prior to
4
Closure
Reopening
Free Residual Chlorine
(1-4 are measurements spread evenly thru the closure time)
pH
(1-4 are measurements spread evenly thru the closure time)
Date (mm/dd/yyyy) that Water Feature was Reopened
Time that Water Feature was Reopened
Total Contact Time
(Time from when disinfectant reached desired level to when
disinfectant levels were reduced prior to opening)
Remediation Procedure(s) Used and Comments/Notes

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