Get Note Please Keep Record Of Operation At Pool Location For Health Department Review

Filling out the NOTE PLEASE KEEP RECORD OF OPERATION AT POOL LOCATION FOR HEALTH DEPARTMENT REVIEW form accurately is essential for maintaining public health standards. This guide provides clear instructions for completing the form online, ensuring that users can efficiently document pool operations for health department review.

Follow the steps to complete the form accurately and efficiently.

1. Begin by locating the form online. Click the ‘Get Form’ button to access the document and open it in the available editor.
2. Fill in the **POOL** section with the name or designation of the pool you are documenting. Ensure this is an accurate representation of the location.
3. In the **STATION** field, specify the station or facility associated with the pool operation.
4. Record the **YEAR** during which the operational data is being collected.
5. For each month of the year, fill in the **TOTAL FREE CHLORINE** and **TOTAL FREE CHLORINE RESIDUAL** details as applicable.
6. Indicate the **FLOW RATE GPM** to reflect the flow rate of the water being treated.
7. Document the **CLARITY**, assessed in the morning and afternoon, to report on water visibility.
8. Record the **WATER TEMP** to monitor the pool water temperature.
9. Fill in the **WATER BALANCE** section to ensure the pool's chemical balance is maintained.
10. Complete the **CHEMICALS ADDED** section with any additional chemicals used during operation.
11. In the **pH** field, measure and indicate the pH level of the pool water.
12. Document the **SATURATION INDEX** to assess the water's corrosiveness or scale-forming tendency.
13. Specify the **RESPONSIBLE PERSON ON DUTY** who is overseeing the pool operation.
14. Fill in **CALCIUM HARDNESS** to ensure that water hardness is within acceptable levels.
15. Record the **TOTAL # USING POOL** to account for the number of users each day.
16. In the **DID THE INJURY REQUIRE HOSPITAL OR DR’S CARE?** section, note any injuries that occurred.
17. If any injuries happened during pool use, respond to **WAS ANYONE INJURED IN POOL? IF SO, WHEN?** with accurate details.
18. Make sure to sign the form in the **SIGNATURE OF OPERATOR** field.
19. If an injury occurred, complete the relevant section on the back of the form detailing the injury report.
20. Review all entries for accuracy before the final submission. Ensure the completed report is submitted to the local health department.
21. After ensuring all information is correct, you may save changes to your online document, download, print, or share the form as needed.

Complete your forms online today to ensure compliance and support public health!