English Instructor Manual (PDF) - Metric Version - National ...
English Instructor Manual (PDF) - Metric Version - National ...
English Instructor Manual (PDF) - Metric Version - National ...
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APPENDIX U<br />
Sample Swimming Pool Inspection Report (CPI)<br />
POOL’S NAME<br />
(Sample) Swimming Pool Inspection Report<br />
INSPECTION DATE<br />
MO. DAY YEAR<br />
STREET ADDRESS TOWN, VILLAGE OR CITY COUNTY<br />
LOCATION<br />
CODE AND<br />
NUMBER<br />
PREVIOUS<br />
ACTION<br />
FUTURE<br />
ACTION<br />
0 1<br />
COUNTY<br />
FACILITY CODE<br />
POOL CAPACITY INSPECTION TYPE INSPECTION RESULTS<br />
PURPOSE DATE STATUS STATUS DATE SCHEDULED ACTION ACTION DATE<br />
PURPOSE DATE CRITICAL NOTICES<br />
Routine<br />
Reinspection<br />
Pre Operation Complaint<br />
Incident/Investigation<br />
Satisfactory<br />
Unsatisfactory<br />
Based on the inspection this day, the items circled below identify violations in operation of facilities that must be corrected.<br />
1<br />
2<br />
3<br />
4<br />
5<br />
6<br />
7<br />
8<br />
9<br />
10<br />
11<br />
12<br />
13<br />
14<br />
15<br />
16<br />
17<br />
18<br />
19<br />
20<br />
21<br />
22<br />
23<br />
DESIGN & CONSTRUCTION<br />
Plans submitted, approved<br />
Pool designed and constructed<br />
SAFETY & SUPERVISION<br />
Maintenance staff, qualified, trained<br />
Supervisor - present, qualified<br />
Staffing - no. of lifeguards<br />
Lifeguards or instructors qualified, certified<br />
Staffing - whirlpools have attendant or television camera monitored<br />
Waterslide attendant<br />
Lifeguards identifiable, no distracting duties, at duties station<br />
Safety - general, no hazardous conditions<br />
Adequate lighting, accessibility, shutoffs<br />
Rescue equipment, first aid equipment, telephone present, located, good<br />
condition, phone numbers posted; gas CI safety equipment<br />
Safety rope as required<br />
Waterslide plunge area separated<br />
Pool rules - posted, legible, located<br />
Maximum pool attendance posted, pool closed sign<br />
Chemicals - proper labeling and storage, no mixing of chemicals,<br />
smoking prohibited<br />
Security - pool enclosure, controlled access, self-closing gates and<br />
latches, access through bathhouse<br />
Pool rules enforced - communicable disease, showers, food, glass,<br />
animals prohibited. Maximum patron loading.<br />
RECIRCULATION SYSTEM<br />
Potable water supply; wastewater - proper disposal<br />
Separate recirculation systems for each pool - New<br />
Recirculation system continuously operated<br />
Skimmers, gutters, drains, water inlets - number, clean, good repair,<br />
installed, operated<br />
Agitation system-designed, maintained<br />
Water level maintained<br />
Proportional flow - gutter or skimmers versus drain<br />
Circulation rate-turnover<br />
Pool volume _____ gals ) flowmeter _____ gpm ) 60 =<br />
Turnover time _____ hrs.<br />
Pump installed, maintained; strainer baskets or screens clean, spares on<br />
hand<br />
Gauges maintained, operated, accurate, installed, approved; pressure or<br />
vacuum gauge<br />
_____ psi inf. _____ psi eff/comb.<br />
Surge tank operated, maintained<br />
Plumbing - air-gaps, cross-connections, maintained, installed; piping<br />
coded or labeled<br />
Filter backwashed or cleaned, maintained, operated, installed<br />
Replacement cartridges sand _____D.E. Cart. _____<br />
24<br />
25<br />
26<br />
27<br />
28<br />
29<br />
30<br />
31<br />
32<br />
33<br />
34<br />
35<br />
36<br />
37<br />
38<br />
39<br />
40<br />
41<br />
42<br />
43<br />
44<br />
CHEMICAL & FILTER-AID FEEDING<br />
Approved design, data plate, interwired with recirculation pump<br />
Disinfectant feeders – proper for chemical used, maintained, installed,<br />
operated, sized. Chemical decanted. *Gas chlorine.<br />
*CI gas safety items under #08, 11<br />
Filter-aid feeders and chemical feeders, installed, maintained, operated<br />
Automatic monitoring and feed controls maintained, operated<br />
POOL CHEMISTRY & QUALITY<br />
Approved chemicals – registered, measurable, compatible, nontoxic, safe<br />
Disinfectant provided, continuous, proper concentration<br />
Superoxidation - done as needed<br />
pH, alkalinity within limits or balanced<br />
Cyanuric acid - within limits<br />
Water quality - clarity, algae control<br />
Microbiology _____ Safe _____ Unsafe (Follow-up - ASAP)<br />
Temperature - within limits<br />
Accurate thermometers, approved test kits unavailable, maintained, used<br />
Frequency of testing - 2x/day-pools, 4x-/day-whirlpools; alkalinity,<br />
cyanuric acid done at least weekly<br />
Reports complete and submitted. Copies kept 2 years, available on-site<br />
EQUIPMENT, MAINTENANCE, CLEANING<br />
Pool equipment – designed, constructed<br />
Pool equipment – cleaned, maintained<br />
Pool and deck – maintained, cleaned, good repair; depth markings,<br />
boundary line<br />
General maintenance, walls, ceilings, floors, hosing; spectator area<br />
separated, maintained<br />
Toilet, shower, dressing rooms, drinking fountain provided as needed,<br />
clean, maintained, hand drying, toilet tissue<br />
Suits, caps, or towels provided to patrons - clean, thoroughly laundered,<br />
storage<br />
Water heaters, heating, ventilation and electrical provided as necessary,<br />
good repair, operated<br />
Solid waste, garbage storage and disposal<br />
Disinfectant used ________________________________<br />
Filter aid; if any __________________________________<br />
Free chlorine residual __________________________ ppm<br />
Combined chlorine ____________________________ ppm<br />
Cyanuric Acid _________________________________ ppm<br />
Bromine _____________________________________ ppm<br />
Water temp._____ o F. Air temp. _____ o F.<br />
pH _____<br />
Alkalinity _____ ppm<br />
INSPECTION BY: (Signature) REPORT RECEIVED BY: DATE:<br />
© 2014 <strong>National</strong> Swimming Pool Foundation® Page 219
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