113 Metro Drive, Anderson SC 29625
888-669-7551 | www.duffieldaquatics.com
Preventative Maintenance
Customer Report
Date
*
-
Month
-
Day
Year
Date
Date Picker Icon
Work Order Name
*
Facility Name
*
Site Name
*
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Time In
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Time Out
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Technician Name
*
First Name
Last Name
Technician Email
*
example@example.com
Technician Mobile
*
-
Area Code
Phone Number
Territory Manager Name
First Name
Last Name
Territory Manager Email
example@example.com
Overall Condition of Pool
1
2
3
4
5
Water Test
ORP
*
pH
*
Chlorine
*
CYA
*
Calcium Hardness
*
Total Alkalinity
*
Temperature
*
TDS
*
CSI Index
pH + CHF + TAF + Temp - TDS
Equipment
CO2
CO2
System Notes
Controller
Controller
System Notes
Chemical Feed - Liquid Chlorine
Chemical Feed - LIquid Chlorine
System Notes
Chemical Feed - pH
Chemical Feed - pH
System Notes
Pulsar System
Pulsar System
System Notes
Filter
Filter
System Notes
Saline Chlorination System
Saline Chlorination System
System Notes
UV
UV
System Notes
VFD
VFD
System Notes
More
Recommendations
Parts Used
Signatures
Tech Signature
Clear
Customer Signature
Clear
Submit
Clear Form
Print Form
Should be Empty: