Weekly Pool Operation And Incident Report

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Weekly Pool Operation and Incident Report
Week Beginning (m/d):
Week Ending (m/d):
Type pool
Setting
Special feature
Pool design
Flow rates:
Name of facility
Pool surface area (sf )
Req’d. turnover rate (min)
o Pool
o Wading pool
o Kiddie slide
o SPA
o Zero entry
o Playground slide
Address
o SUP
o Spray
o Rec slide
Pool volume (gal)
Min. req’d. flow ( gpm)
ground
o Water slide
o Fountain
City
o Other ____________
Max allow filter flow (gpm)
First reading at opening,
Chemical adjustments # = lbs; g=grams; gal=gallons; L=liters; ppm=parts per million
Testing frequency: OAC 3701-31-04
Daily testing
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Time of test
Free Cl (ppm)
Combined Cl (ppm)
Total Cl (ppm)
Total bromine (ppm)
pH
Water clarity
Water temp(F
0
)
Cyanuric acid (ppm) as applies
Total alkalinity (ppm)
*Monopersulfate (oY/oN) as applies
Disinfection
Hyperchlorination (gal/#) (m/d)
Acid(#)
Sodium carbonate (soda ash) (#)
Bicarbonate(#)
Flow measurement (gpm)
Press/Vac gauge(psi)
Filter backwash (m/d)
Pool drainage (m/d)
ACC functional/tested monthly (m/d)
SVRS functional/tested monthly (m/d)
Pool Closed
ORP/HRR
Secondary disinfection oUV light
oCopper –silver
oOzone
Calcium hardness (ppm)
Bather load
*Monopersulfate interferes with DPD test kit reagents to provide inaccurate results. Monospersulfate is used as a non-chlorine shock to oxidize organic contaminates in the pool
HEA 5219 rev (4/11)

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