Title Page

  • This Document is Prepared by (name):

  • Customer/Client Name & WO/Job Number

  • Location
  • Conducted on

Cooling Tower Information

  • Tower ID

  • Location

  • Make

  • Model

  • Serial Number

  • Water Treatment

  • Use

  • Basin Capacity

  • Pre-task plan procedure has been completed

  • PPE (personal safety equipment) has been utilized.

Spring Cooling Tower Inspection

  • IMPORTANT INFORMATION TO REMEMBER:
    1. Ensure tower water stays off your clothes.
    2. Do not touch any part of your face until hands are washed.
    3. No eating, drinking or smoking near the cooling tower.

Spring Cooling Tower Inspection: The following steps should only be checked IF you are performing a SPRING COOLING TOWER INSPECTION. Otherwise find the checklist for Fall inspection.

  • Review water treatment tests to ensure no legionella bacteria has been detected. Test results must be performed within the last 90 days of today's service. Test results should be located either near the cooling tower or in the store manager's office. If the information is vague or incomplete please call the water treatment company for clarification. If you still have questions, please contact either the Service Manager or the Safety Coordinator.

  • Walk around unit and check for excessive algae buildup, foul smells and mold buildup. If any of these are present, please consult your supervisor.

  • Lock-out/ Tag-out equipment.

  • Verify back flow preventer on make-up water line.

  • Clean tower sump and flush.

  • Clean and inspect spray nozzle.

  • Check water flow distribution over media and through nozzles.

  • Replace all drain plugs and caps.

  • Check belts if applicable.

  • Once tower is flushed, remove and clean tower pump strainer.

  • Check tower fill valve, float assembly and fill tower with water.

  • Inspect drift eliminator a and fill material for cleanliness.

  • Check spray pump amps.

  • Check fan(s) starter, starter contacts and electrical connections.

  • Inspect tower fan motor, reduction gear. Lubricate as necessary and check gear oil.

  • Examine sheaves/pulleys and lubricate bearings.

  • Check tower fan cycling control if applicable.

  • Check dampers if applicable.

  • Start tower pump and check water flow over media, balancing water flow if needed.

  • Signature of tech who prepared this form.

Fall Cooling Tower Inspection Checklist

  • IMPORTANT INFORMATION TO REMEMBER:
    1. Ensure tower water stays off your clothes.
    2. Do not touch any part of your face until hands are washed.
    3. No eating, drinking or smoking near the cooling tower.

Fall Cooling Tower Inspection: The following steps should only be checked IF you are performing a FALL COOLING TOWER INSPECTION. Otherwise find the checklist for Spring inspection.

  • Review water treatment tests to ensure no legionella bacteria has been detected. Test results must be performed within the last 90 days of today's service. Test results should be located either near the cooling tower or in the store manager's office. If the information is vague or incomplete please call the water treatment company for clarification. If you still have questions, please contact either the Service Manager or the Safety Coordinator.

  • Walk around unit and check for excessive algae buildup, foul smells and mold buildup. If any of these are present, please consult your supervisor.

  • Lock-out/Tag-out equipment

  • Drain tower and secure fill valve. Drain fill line to prevent freezing.

  • Examine sump heaters and heat trace if applicable.

  • Drain tower lines to prevent freezing.

  • Secure and lock-out power to tower fan(s) and to pump(s).

  • Coordinate with water treatment company to schedule annual disinfection.

  • Signature of tech who prepared this form.

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.