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GMSS Chemical Check Form
Chemical Check
Staff Information
First Name
*
Last Name
*
Email
*
Date
*
MM slash DD slash YYYY
Time of Test
*
:
Hours
Minutes
AM
PM
AM/PM
Chemical Check Instructions
Overview
Chlorine
Chlorine Instructions
Free Available Chlorine (FAC)
*
#Drops x 0.2
Range 1.5 to 2.0
1.0 = State Minimum while in use
Please Select
0.0
0.2
0.4
0.6
0.8
1.0
1.1
1.2
1.4
1.6
1.8
2.0
2.2
Other
Other FAC
Please enter the value for FAC
Auto Feed (Minutes)
*
Based off the FAC, how long was the auto-feed?> 0,1,5,10,15,20 minutes
Chlorine Auto feed
Please Select
0 minutes
1 minute
5 minutes
10 minutes
15 minutes
20 minutes
Combined Chlorine (CC)
*
#Drops x 0.2
Range 0.0 -0.4, Ideal 0.0
Please Select
0.0
0.2
0.4
Other
Other CC
Please enter the value for CC
pH
pH Instructions
pH Level
*
pH range 7.2 - 7.6
Ideal 7.4
Please Select
7.3
7.4
7.5
7.6
Other
Other pH
Please enter the value for pH
Alkalinity
Alkalinity Instructions
Alkalinity
*
#Drops x 10
1/3 Red Bucket = 10 Points
Range 80-130, Ideal 110
Please Select
80
90
100
110
120
Other
Other Alkalinity
Please enter the value for Alkalinity
Adding Sodium Bicarbonate
*
If Sodium Bicarbonate was added to the pool, how full was the red bucket?
#Drops x 10
1/3 Red Bucket = 10 Points
Range 80-130, Ideal 110
Please Select
none
1/3
2/3
whole
H2O
Water Temperature
*
Range 90-92, Ideal 91
Please Select
90
91
92
Other
Other Water Temperature
Please enter the value for Water Temperature
Pool Flow Rate
Pool Flow Rate
*
Range 250-450; Ideal 375
Position of the Gutter Valve?
Please look down at the blue handle on the pipes below the pool flow rate monitor and using the hour hand of the clock, what time is the valve positioned at?
CAT ORP
CAT ORP Setpoint
*
Ideal 600
CAT Controlling ORP
*
Range 650-900; Ideal 850
CAT Alarms
*
Are there any CAT Controller alarms?
Please Select
Yes
No
If you answered YES to CAT Alarms, what were the alarms?
CAT Bubbles
*
Are there any bubbles in any of the flow meters on the CAT Controller?
Please Select
Yes
No
If you answered YES to CAT Bubbles, where were the bubbles?
Ozone
Ozone ORP
*
Range 650-900, Ideal is 850
Additional Notes or Findings in the Pump Room
Section Break
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Facility Tour
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What is the student's age?
3 months to 2 years
2 years to 3 years
3 years to 12 years
13 years to 17 years
18+ years
Do you want to swim with the student?
Yes (recommended)
No
Can the student independently submerge and swim back to the side of the pool?
Yes
No
Can the student independently jump into the pool, float on their back, and kick to the side of the pool?
Yes
No
Can the student swim Backstroke?
Yes
No
Can the student swim Freestyle?
Yes
No
Can the student swim Butterfly?
Yes
No
Can the student swim Breaststroke?
Yes
No
Awesome! We recommend
BABY SWIM!
Age 3 months to 36 Months
No swimming experience is required
Parent/caregiver participation required
6 students/adults to 1 instructor
30-minute class, 1 x per week
LEARN MORE ABOUT BABY SWIM
Awesome! We recommend
STARFISH
!
Age 2 years to 12 years
No swimming experience is required
No Parent/caregiver participation
3:1 student to teacher ratio
30-minute class, 1 x per week
LEARN MORE ABOUT OUR STARFISH - LEARN TO SWIM PROGRAM
Awesome! We recommend
DOLPHIN
!
Age 2 years to 12 years
Seahorse graduate
4:1 student to teacher ratio
30-minute class, 1 x per week
LEARN MORE ABOUT OUR DOLPHIN - LEARN TO SWIM PROGRAM
Awesome! We recommend
SWIM TEAM
!
Competitive swim program
For ages 6 and up
Experienced coaches
Practice multiple times per week
LEARN MORE ABOUT OUR SWIM TEAM PROGRAM
Awesome! We recommend
ADULT
!
Age 13 years or older
No swimming experience is required
6:1 student to teacher ratio
60-minute class, 1 x per week
LEARN MORE ABOUT OUR ADULT SWIM PROGRAM
Awesome! We recommend
SWIM TEAM
or
ADULT
!
SWIM TEAM
Age 5 years to 17 years
Stingray Graduate
Must be able to accurately swim all four strokes: Butterfly, Backstroke, Breaststroke, and Freestyle
Indoor or Outdoor options
LEARN MORE ABOUT OUR SWIM TEAM PROGRAM
ADULT
Age 13 years or older
No swimming experience is required
6:1 student to teacher ratio
60-minute class, 1 x per week
LEARN MORE ABOUT OUR ADULT SWIM PROGRAM
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