Lodge #1440 Forms

Lodge Forms

Used for tracking testing & volunteer time on swimming pool

Your Name:

Email Address:

Total Chlorine 1 to 10 ppm:

pH:

Temp:

Comments Notes or Corrective Action:

CPO Notified:

Yes No

Pool Status on Test Completion:

Open for Swim
Closed due to results
Closed due to pool hours
Closed for HAZARD

Security Code. Please enter the number you see above: