Free Florida DH 921 filler
Florida DH 921 pool log: fill it on your phone, print the month
Enter each day's chlorine, pH and filter readings. Chlorlog keeps them on this device and prints a filled Monthly Swimming Pool Report in the form's layout.
Form source: DH 921, 3/98, Florida Department of Health, floridahealth.gov, read October 21, 2026. Ranges from rule 64E-9.004, F.A.C.
Monthly Swimming Pool Report
| Days of month | Chlorine residual | pH | Filter gauge reading | Flow GPM | Pool vacuumed | No. patrons | RemarksTotal alkalinity, hardness, cyanuric acid, equipment breakdown, excessive pool water loss, filter backwash, water clarity | ||||||
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| 9 AM | 1 PM | 4 PM | 9 AM | 1 PM | 4 PM | Vacuum in/Hg | Pressure: influent PSI | Pressure: effluent PSI | |||||
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Swipe the table sideways to see every column.
* Reading outside the range in rule 64E-9.004, F.A.C. for the pool type conventional swimming pool (outdoor): chlorine residual 1 to 10 mg/L, pH 7.0 to 7.8.
Layout follows Florida form DH 921, 3/98 (Monthly Swimming Pool Report), floridahealth.gov, read October 21, 2026.
Operators remain responsible for their records. Check with your county health department for anything your inspector needs beyond the form. Bromine readings can be typed into Remarks but are not range-checked; only chlorine and pH are.
The Florida requirement
What rule 64E-9.004(11) asks you to keep
A daily record
The pool owner or operator keeps a daily record of pool operation on form DH 921, or a customized form with the same information.
Tests by hand
Manually conducted tests for pH and disinfectant at least once every 24 hours, and weekly cyanuric acid when chlorinated isocyanurates are used.
Kept at the pool
The completed report stays at the pool and is made available to the department on request. Any able person can test the water and record it.
FAQ
DH 921 questions
Which form does this follow?
Form DH 921, 3/98, Monthly Swimming Pool Report, from the Florida Department of Health (floridahealth.gov), read October 21, 2026. The printout has the same fields: state permit number, date, pool name, address, pool volume, and for each day chlorine residual and pH at 9 AM, 1 PM and 4 PM, filter vacuum, influent and effluent pressure, flow, pool vacuumed, number of patrons and remarks.
Can I use this printout instead of the paper form?
Rule 64E-9.004(11), F.A.C. says customized report forms may be substituted provided they contain the appropriate information and are made available to the department. Chlorlog is not affiliated with or approved by the Department of Health, so if you are unsure, show a printout to your county health department.
What does a marked reading mean?
A chlorine residual or pH value outside the range in rule 64E-9.004(1)(d) for the pool type you chose: pH 7.0 to 7.8, and free chlorine 1 to 10 mg/L (conventional), 1 to 5 (indoor conventional), 2 to 5 (spa-type) or 2 to 10 (other pool types). It is marked with an asterisk on the printout. Chlorlog does not decide whether your pool meets the rules.
Where are my readings saved?
In this browser on this device, as you type. Nothing is uploaded and there is no account. Clearing your browser data, or using a private window, removes them, so print or save each month as a PDF.
How do I save the month as a PDF on a phone?
Tap Print or save as PDF. On iPhone, choose Save to Files or share from the print preview. On Android, choose Save as PDF as the printer.
Where do total alkalinity and cyanuric acid go?
In Remarks, as on the paper form. The rule asks for weekly cyanuric acid tests when chlorinated isocyanurates are used.
Outside Florida?
Use the daily pool log sheet: the core readings, filled and printed the same way.