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WebA swimming pool incident report template is used to record incidents such as injuries, vomit, fecal, blood contamination, near-drowning, drowning, or others. Use this template to … WebSWIMMING POOL RECORD OF OPERATION State Form 12279 (R5 / 4-11) INDIANA STATE DEPARTMENT OF HEALTH Pursuant to 410 IAC 6-2.1 and 38, this form must be logged daily and retained for one (1) year. Name of facility Week ending date (month, day, year) Type of pool (indoor, outdoor, wading, wave, spa, waterslide, other pool) Day DAILY WEEKLY …
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