• Job Number

  • Job Name

  • Report Prepared By:

  • Select date

  • Floor:

  • Area:

  • Room/Corridor

Sump Pumps

  • Sump Pits are clean and free of debris prior to setting?

  • Picture of sump pit prior to installation

  • Is entry to the pit required to install pumps?

  • Has a work plan been developed?

  • Has the safety department been notified of the confined space entry?

  • Guide rails are installed and material is per submittal?

  • Floats are installed at correct elevation and per detail?

  • Coordination with electrician is complete, float and power cables are of sufficient length?

  • Picture of power and float cables

  • All O&M manuals that came with the pumps have been given to the PM to compile the turn over package?

  • Manufacturers Rep has been onsite to assist with start up of pumps?

  • Name of Manufacturers Representative:

  • Date or Dates Rep was on site:

  • Electrical/Control panel location has been coordinated and complies with electrical clearances required?

  • Photo of Installed Panel

  • Pit Lid matches frame and gasket and all bolts are installed?

  • Picture of installed pit lid

Water Softener

  • Anchorage complies with details?

  • All Clearances required for maintenance or service have been addressed and adhered to?

  • Photo of clear service area

  • Flex connectors installed on connection to softener if required?

  • Softening media installed if required?

  • Manufacturers Rep has confirmed installation is correct and assisted in start up?

  • Name of Manufacturers Rep

  • Date or Dates Manufacturers Rep was on site

  • Drains off equipment are run to floor sink and drain properly?

  • Water softener installed on housekeeping pad if required?

  • Photos of completed installation

Expansion Tank

  • Anchorage complies with approved details

  • Piping is installed to tank with union and valves as required?

  • Piping is connected to cold water system per detail?

  • Pre Charge Pressure of the tank has been confirmed?

  • All O&M Manuals that came with the tank have been given to the PM for the turn over package?

  • Tank is on housekeeping pad if required?

  • Picture of completed installation

Domestic Water Heaters

  • Piping to heaters complies with approved detail?

  • All valves, gauges, reliefs thermometers are installed per detail?

  • All Clearances for maintenance have been adhered to?

  • Coordination with Electrical, Control, and Mechanical (steam) has been completed and clearances met?

  • Anchorage of heaters is per approved detail?

  • Housekeeping pad is installed if required?

  • Flex connectors installed at equipment if required?

  • Relief valves are run to floor sink?

  • Manufacturers Rep has approved the installation and has assisted in start up?

  • Name of Manufacturers Rep:

  • Date or Dates Manufacturers Rep was on site

  • Start up Documentation and compliance is complete and given to the PM?

  • Insulation of equipment is complete if required?

  • Picture of the completed installation

Circulating Pumps

  • Circulating pumps installed per contract details?

  • Pumps are properly supported?

  • Picture of pump support

  • Flex connectors installed if required?

  • Aqua stat, timer and control panel installed?

  • Timer and control panel are accessible and required clearances met?

  • All O&M paperwork with with pumps has been given to the PM for the turn over package?

  • Oil for bearings and seals has been installed if sent with pumps?

  • Picture of completed installation

Thermostatic Mixing Valve

  • Mixing Valve has been installed per the manufacturers instructions?

  • Mixing Valve is supported properly?

  • Picture of mixing valve support

  • Mixing Valve is accessible?

  • O&M Manual has been given to the PM for the turnover package?

  • Picture of completed installation

Notes, Impacts, or Comments

  • Notes, Impacts or Comments

  • Signature of report preparer:

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.