Swimming Pool Chemical Log Sheet
Swimming Pool Log Sheet
Pool Name: Type of Disinfectant:
Month:
Year:
Size of Pool (gallons):
Flow Rate Required (GPM):
Minimum of 1.5 PPM if inorganic chlorine, 2.0 PPM if stabilized or organic, and 2.5 PPM if Bromine.
Date
Water Clarity
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Daily Tests
Disinfectant PPM
Combined Chlorine < 50% free
pH 7.2-8.0
Flow GPM
Weekly Tests
Alkalinity Cyanuric Rec. Range Acid if 60-160 PPM used < 90
Chemicals Added
Quantity of
Other
Disinfectant Chemicals
Added
Added
Maintenance & Notes
Back- Vacuum Contaminant wash or Brush Episode
DOH 333-132 November 2012
Swimming Pool Log Sheet
Washington State Department of Health
doh.watersafety
Date
Water Clarity
16
17
18
19
20
21
22
23
24
25
26
27
28
29 30 31
Daily Tests
Disinfectant PPM
Combined Chlorine < 50% free
pH 7.2-8.0
Flow GPM
Weekly Tests
Alkalinity Cyanuric Rec. Range Acid if 60-160 PPM used < 90
Chemicals Added
Quantity of
Other
Disinfectant Chemicals
Added
Added
Maintenance & Notes
Back- Vacuum Contaminant wash or Brush Episode
DOH 333-132 November 2012
Swimming Pool Log Sheet
Washington State Department of Health
doh.watersafety
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