Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Site type

  • Cabinet inspection

  • Space available

  • Site operation

  • Wiring

  • Meter location

  • Meter reading

  • Meter reading

  • Supply potable

  • Pumps

  • Make

  • Model

  • Size

  • Starter

  • Age

  • Tank Size

  • Tank Type

  • Discharge pipe size

  • Meter size required

  • Valve 1 operates

  • Ohms

  • Notes

  • Valve 2 operates

  • Ohms

  • Notes

  • Valve 3 operates

  • Ohms

  • Notes

  • Valve 4 operates

  • Ohms

  • Notes

  • Valve 5 operates

  • Ohms

  • Notes

  • Valve 6 operates

  • Ohms

  • Notes

  • Valve 7 operates

  • Ohms

  • Notes

  • Valve 8 operates

  • Ohms

  • Notes

  • Valve 9 operates

  • Ohms

  • Notes

  • Valve 10 operates

  • Ohms

  • Notes

  • Valve 11 operates

  • Ohms

  • Notes

  • Valve 12 operates

  • Ohms

  • Notes

  • Valve 13 operates

  • Ohms

  • Notes

  • Valve 14 operates

  • Ohms

  • Notes

  • Valve 15 operates

  • Ohms

  • Notes

  • Valve 16 operates

  • Ohms

  • Notes

  • Valve 17 operates

  • Ohms

  • Notes

  • Valve 18 operates

  • Ohms

  • Notes

  • Valve 19 operates

  • Ohms

  • Notes

  • Valve 20 operates

  • Ohms

  • Notes

  • Valve 21 operates

  • Ohms

  • Notes

  • Valve 22 operates

  • Ohms

  • Notes

  • Valve 23 operates

  • Sprinkler

  • Notes

  • Valve 24 operates

  • Sprinkler

  • Notes

  • Valve 25 operates

  • Sprinkler

  • Notes

  • Valve 26 operates

  • Sprinkler

  • Notes

  • Valve 27 operates

  • Sprinkler

  • Notes

  • Valve 28 operates

  • Sprinkler

  • Notes

  • Valve 29 operates

  • Sprinkler

  • Notes

  • Valve 30 operates

  • Sprinkler

  • Notes

  • Valve 31 operates

  • Sprinkler

  • Notes

  • Valve 32 operates

  • Sprinkler

  • Notes

  • Valve 33 operates

  • Sprinkler

  • Notes

  • Valve 34 operates

  • Sprinkler

  • Notes

  • Valve 35 operates

  • Sprinkler

  • Notes

  • Valve 36 operates

  • Sprinkler

  • Notes

  • Valve 37 operates

  • Sprinkler

  • Notes

  • Valve 38 operates

  • Sprinkler

  • Notes

  • Valve 39 operates

  • Sprinkler

  • Notes

  • Valve 40 operates

  • Sprinkler

  • Notes

  • Valve 41 operates

  • Sprinkler

  • Notes

  • Valve 42 operates

  • Sprinkler

  • Notes

  • Valve 43 operates

  • Sprinkler

  • Notes

  • Valve 44 operates

  • Sprinkler

  • Notes

Existing controllers

  • Type

  • Communication

  • Controller 1

  • Model

  • Stations used

  • Address

  • Address pump start

  • Station Qnt

  • MV Output(s)

  • Comments

  • Controller 2

  • Model

  • Stations used

  • Address

  • Address pump start

  • Station Qnt

  • MV Output(s)

  • Comments

Monitoring

  • Site inputs - FIELD LIGHTS Qnt

  • Notes

  • Site inputs - OTHER LIGHTING Qnt

  • Notes

  • Site inputs - TOILET BLOCKS Qnt

  • Notes

  • Site inputs - OTHER Qnt

  • Notes

  • Site inputs - GAS METER Qnt

  • Notes

  • Site inputs - BBQ ELECTRIC Qnt

  • Notes

  • Site inputs - BBQ GAS Qnt

  • Notes

  • Site inputs - SECURITY Qnt

  • Notes

  • Site inputs - IRRIGATION PUMPS Qnt

  • Notes

  • Site inputs - SEWERAGE PUMPS Qnt

  • Notes

  • Site inputs - STORM WATER PUMPS Qnt

  • Other

General notes

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.