Chemical Sanitizer Monitoring Form

October 2, 2014

Download the Chemical Sanitizer Monitoring Form

Directions

  • Complete this form daily.
  • Record date, your initials and test strip results.
  • Indicate whether the test strip turned the appropriate color to meet the sanitizer concentration standard. The result is either ”OK“ or ”CHANGED.“ If the solution is changed, indicate corrective action on the form.
  • If the sanitizer solution is redone, log the new concentration on the form.

Sanitizer Standards

Chlorine- 50 to 200 ppm
Quaternary Ammonia-200 ppm
Hydrogen Peroxide-300 ppm

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