Exterior Inspection Record

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					                                                                                                                                                                     AHA! Resource Manual

                                                              Perform sampling at a frequency of ________________.
A.3 - Chlorine Testing Record                                 Take a sample of water from a random tap in processing area before, during, and at the end of production.
                                                              Test chlorine level using the procedure in the chlorine test kit.
Completed by: ______________________________
                                                              If water reading does not show levels between 0.3 mg/L and 0.5 mg/L, adjust chlorine pump accordingly
Date: _____________________________________                    and retest chlorine levels.

          Sample                    Sample       Sample                Free Chlorine             Results                          Correction                   Retest
                                                                                                                                                                              Initials
           Date                     Location      Time                    Level                Acceptable                            Made                      Results




  Additional Comments:




Onsite verification completed by:                              Date:                                                Deviations/comments:




Record verification completed by:                              Date:                                                Deviations/comments:




Premises Program: Chlorine Testing Record                                                                                                                                      Page 1 of 1

Issue Date: _______________________

Developed by: ____________________________                                                                                                 Date last revised: ____________________________

Authorized by: ____________________________                                                                                                Date authorized: ____________________________



                                               The Agricultural Policy Framework (APF) A FEDERAL – PROVINCIAL - TERRITORIAL INITIATIVE

				
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