Body Fluid Contamination Response Log Person Carrying out Contamination Supervisor on Duty Response Date (mm/dd/yyyy) of Time of Incident Number of Incident Response Response People in Water Water Feature or Area Contaminated Specify Type/Form of Formed stool Diarrhea Vomit Blood Contamination Stabilizer Used in _____ YES _____ NO Water? Taken 6 times during disinfection Water Quality (once every ____ minutes) Measurements Prior to Closure 4 1 2 3 Reopening Time at Measurements Free Residual Chlorine pH Time that Water Date (mm/dd/yyyy) that Feature was Water Feature was Reopened Reopened Total Contact Time From ______ To ______ (Time from when disinfectant reached target level to when Total Time Lapse ______ disinfectant levels were reduced prior to opening) Remediation Procedure(s) Used and Comments/Notes
Body Fluid Contamination Response Log Person Carrying out Contamination Response Supervisor on Duty Date (mm/dd/yyyy) of Incident Response Time of Incident Response Number of People in Water Water Feature or Area Contaminated Specify Type/Form of Contamination Formed stool Diarrhea Vomit Blood Stabilizer Used in Water? _____ YES _____ NO Water Quality Measurements Taken 6 times during disinfection (once every ____ minutes) Closure 1 2 3 4 Prior to Reopening Time at Measurements Free Residual Chlorine pH Date (mm/dd/yyyy) that Water Feature was Reopened Time that Water Feature was Reopened Total Contact Time (Time from when disinfectant reached target level to when disinfectant levels were reduced prior to opening) From ______ To ______ Total Time Lapse ______ Remediation Procedure(s) Used and Comments/Notes
Body-Fluid-Contamination-Response-Log.docx