Daily Pool Record Sheet

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Today's Date
		Time A.M. / P.M.			Time A.M. / P.M.
* Total Alkalinity s .7(7)	Between 80 - 120ppm		Cyanuric Acid s .7(11)	Less than 60ppm
Emergency Phone 1/2 hr before opening s. 8, 16(2)	Satisfactory   OR   Unsatisfactory		Ground Fault Interrupter 1/2 hr before opening s. 8, 16(2)	Satisfactory   OR   Unsatisfactory
Make-up Water 20L per bather per day s. 8			Water Meter Readings s. 7(12)	Pre-fill	Post-fill

Pool Bi-hourly Water Tests
	1/2 hr before opening	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. /p .m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.	Time a.m. / p.m.
Free available Chlorine (FAC) Min 0.5ppm - unstabilized Cl Min 1.0ppm - stabilized Cl s. 7(10), 8
Total Chlorine (TC)/Bromine s. 7(10), 8
Combined Chlorine (CC) TC - FAC = CC * Maximum 0.2ppm
pH Between 7.2 - 7.8 s. 7(10), 8
* Water Clarity Black disc clearly visible from 9m away s. 7(4)
* ORP Reading * Minimum 700mV s. 7(9)(10)
# Bathers s.8												Total

Pool Outlet Covers		Operator Information
Conditions at the Time of Inspection	Actions Taken	First Name	Last Name
		Signature
Record of Emergencies (i.e. rescues, pool fouling), rescue equipment breakdown, backwashing, chemicals added, cleaning s. 8

Health Protection and Promotion Act - R.R.O. 1990, Reg. 565, Public Pools

Note: Niagara Region strongly recommends also recording the * values above.