Step 1 of 6 16% InstagramThis field is for validation purposes and should be left unchanged.Pool Tech - Name(Required) First Last Property Name / Street Info Water ChemistrySanitizer Water Chemistry(Required)Please specify 0-15ppmCombined Chlorine Levels(Required)Please specify between 0-1 ppmpH Levels(Required)Please specify between 6.8-8.2ppmCyanauric Acid(Required)Please specify between 0-150ppm Recirculation SystemRecirculation SystemIs on and operable whenever pool is available for use Yes No Unsure / Needs Attention Anti-Entrapment CoversProperly secured anti-entrapment covers are provided and in good repair for main drain(s), equalizer lines, and all suction outlets. Yes No Needs Attention/Not Sure GaugesGauges are installed and operating properly. Yes No Needs Attention/Not Sure FlowmeterIs installed and operating properly Yes No Needs Attention/Not Sure Automatic ChlorinatorIs installed and operating properly Yes No Needs Attention/Not Sure Skimmer AssemblyIs maintained in good condition, including: basket, weir, and diverter valve. Yes No Needs Attention/Not Sure Notes on Any Notable Issues/Service Needed Safety Hazards & Life Saving EquipmentWater TemperatureIn spas does not exceed 104 degrees Yes No Needs Attention/Not Sure Water is Clean and ClearMaximum depth of pool is clearly visible from the deck. Yes No Needs Attention/Not Sure Spa Emergency Shut OffWorks Properly Yes No Needs Attention/Not Sure Safety SignsSafety signs posted in a conspicuous place and in good condition. Present - In Good Condition Present - In Poor Condition Not Present Body HookBody Hook with attached 12 ft. (min.) pole at poolside.* *Note: Pools exceeding 75 feet in length or 50 feet in width shall have a rescue pole and life ring that is available on at least 2 opposing sides of pool at centralized locations. Present - In Good Condition Present - In Poor Condition Not Present Life Ring(17 in. minimum) with attached rope to span width of pool from poolside is available in good condition Present - In Good Condition Present - In Poor Condition Not Present Are All Gates & Doors Self-Closing/Latching?Gates and doors of the pool enclosure are self-closing and self-latching. Yes No Some (Add to Notes) Do All Gates Have Safety Signage? Yes No Needs Attention (Notate Below) Notes on Any Notable Issues/Service Needed Maintenance & OperationsAlgaeNo algae in pool water, on sides, bottom, or on tiles. Yes No TilesAll tiles on pool sides, on spa benches, and on spa steps are in good repair. Yes No Pool LightingPool light is secure and in good operating condition. Yes No Ladders & HandrailsLadders and handrails are available, secure (not loose), and in good repair. Yes No Log SheetsDaily records of pool maintenance and operations available for inspector's review.* *Complexes with less than 25 units may record required information at least 2 times per week with no more than 4 days between readings. Maintain all records for at least 2 years. Yes No DPD Test Kit AvailableDPD test kit is provided that measures free chlorine residual or bromine, pH, combined chlorine, and cyanuric acid (if used). Yes No Notes on Any Notable Issues/Service Needed Pump InformationPump Model NumberAdd Description if NeededConditionGood / Fair / Needs Repair? Please include notesFilter InformationFilter Model Size or Descriptionie 60, 48 ConditionGood / Fair / Needs Repair? Please include notesChlorine System InformationChlorine System DescriptionAdd as much helpful detail as possibleConditionGood / Fair / Needs Repair? Please include notesHeater InformationHeater Model Number or DescriptionAdd as much helpful detail as possibleConditionGood / Fair / Needs Repair? Please include notesImportant Equipment NotesPlease detail out any service or replacement needs, or special details about the system
