Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Checklist
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Settleometer Reading
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Blower are"
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Bar Screen Cleaned ? Every Visit
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pH Controller Cleaned & Calibrated ? Every Visit
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Caustic Soda Drum Replaced ? As Needed
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Diffusers Cleaned ? As Needed
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Clarifier Surface Cleaned ? Every Visit
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Effluent Pump Station Cleaned ? Monthly
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All 3 Effuent Pumps Operational ? Every Visit
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PAC Drum Replaced ? As Needed
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Sludge Tanks Decanted ? As Needed
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Sludge Wasted ? As Needed
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Dosing Tank Drained ? Every Visit
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UV Bulbs Cleaned ? Every Visit
Quality Control Test
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Ammonia Level:
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Ammonia level tested with:
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Aeration Basin pH: (General Rule pH 7.5-8.0)
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Samples Collected:
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Effluent pH:
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Effluent D.O.
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Effluent CI2:
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Flow: (MGD)