Swimming Pool / Spa
Inspection Report

Linn County Public Health
1020 - 6th Street SE
Cedar Rapids, IA 52401
Phone: (319) 892-6000 Fax: (319) 892-6099
E-mail: health@linncounty.org
  Facility Name: Jefferson High School
Address: 1243 20th St SW
Cedar Rapids, IA  52404
Person Contacted: Mike Hopkins
Title: CPO
Registration No: SP57-041-100
Type: Routine

Water Quality Information
Name: Indoor Pool >= 1500 sq ft
Registration No: SP57-041-100
Area (ft.): 3150
Volume (Sq. ft.): 159847
Filter Type: DE
Filter Rate:
Turnover Rate:
Chlorine (Free): 2.0
ORP: 800
Pool: 1-8ppm, ORP 700-880 mV
If less than 0.6ppm or greater than 8.0ppm = closure
Spa: 2-8 ppm ORP 700-880 mV
If less than 1.0ppm or greater than 8.0ppm = closure
Chlorine (Total): 2.4
Chlorine (Combined): 0.4
Bromine: N/a
Pool: 2-18ppm Spa: 4-18ppm
Water Quality Information (continued)
Cyanuric Acid: N/a
Must be less than 80 ppm
pH: 7.4
Pool and Spa: 7.2ppm-7.8ppm
If less than 6.8 or greater than 8.2 = closure
Total Alkalinity: 250
Calcium Hardness: 110
Temperature (F): N/a
Spa must not exceed 104°
Type of Disinfectant: Chlorine
Smoke Free Air Act
1. Facility in compliance with smoking ban?
( If no, complete complaint form )

Notes: When pool is in use, please be sure to document testing at least 30 minutes prior to the first person entering the pool and every 4 hours after, that the pool is open.

Please reach out to Dave Peters and have him email you a copy of yours and your evening CPO’s certificates, email them to me and keep them in your pool records.

# Section Reference Ref. Page
1) Management/Personnel Pool: 15.4(6)l 25
Spa: 15.51(5)j 18
  Comment: Have all coaches and stafff that works in the pool area sign off on this annually.
  Item: A written emergency plan shall be provided and reviewed annually
2) Management/Personnel Pool: 15.4(6)f(6) 24
Spa: 15:51(5)e(8) 17
  Comment: Be sure to document this monthly.
  Item: Monthly ground fault circuit interrupter (GFCI) shall be included in Operational Records
3) Safety Pool: 15.4(4)f(4) 17
  Comment: First aid kit missing chemical cold press and disposable gloves. Also, please have this in the pool area at all times, not in storage/filter room.
  Item: A first-aid kit shall be equipped with: band-aids, sterile 4x4 bandage compress, self-adhering gauze bandage, disposable gloves, and a chemical cold press.
4) Safety Pool: 15.4(4)h 18 and 19
  Comment: Provide proof of initial installation date and that they are actually 20 year drain covers with 10 year hardware warrantee along with proof that the hardware was recently changed.
  Item: All main drains shall be VGB compliant and within expiration date
5) Safety Pool: 15.4(4)b(4) 13
Spa: 15.51(4)b(2) 13
  Comment: Replace slip resistant material on recessed steps in pool at the time of the next pool drain.
  Item: Stairs, ladder rungs, ramps, and recessed steps shall be slip-resistant.
6) Safety Pool: 15.4(6)k 25
Spa: 15.51(5)i 18
  Comment: Have all coaches and staff that work in the pool area sign off on MSDS sheets annually.
  Item: Copies of MSDS sheets shall be available for employee review. Each member of staff shall review MSDS annually.
  Name   Date
Inspector: Inspection:
Report Received By: Received:
Reviewed By: Reviewed:

These items must be corrected as soon as possible in order to comply with the Iowa Department of Public Health Swimming Pool and Spa Rules. A letter regarding the actions which will be taken in order to correct all deficiencies must be submitted within 30 days to this office. If for any reason you take issue with any of the items cited regarding swimming pool rules, a variance can be requested by following the instructions in the Iowa Department of Public Health Swimming Pools manual, amended July 8th, 2009, page 57, section 641-15.7 (135I). Variance requests regarding spa rules must be made in compliance with the instructions in the Iowa Department of Public Health Spa manual, revised July 8th, 2009, page 32, section 641-15.7 (135I).