Monthly Pool Record

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Monthly Pool Record – Month:______________________ Year:_________
Name of Pool: ______________________________________________ Circle Type of Pool: Swimming, Wading, Spa, Other
CPO Name(s): ____________________________________________________________________________________________
Date
Time
Free Cl
pH
Drains
Temp
TA*
CA*
Maintenance (Backwash, Vacuum, Chemicals)
CPO Signature
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*Check and record total alkalinity (TA) and cyanuric acid (CA) weekly. The Pool Operator shall inspect the pool daily and maintain written records.

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