Example Data Collection Form
System
Date/Time Started
Date/Time Finished
Free Chlorine (if cold) – as ppm Chlorine (must be greater than 0.5 ppm)
Temperature (if hot) > 118 F
Filter change out (yes/no)
Sink in Bathroom 1205 Shower in Bathroom 1205 Drinking Fountain – Asset number 65234
6/1/20 - 8:30 am
6/1/20 – 9:00 am
1.0 ppm
6/1/20 8:35 am
6/1/20 – 9:10 am
118F
6/1/20 9:20 am
6/1/20 10:10 am
1.0 ppm
Yes
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