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
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Job Number
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Job Name
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Report Prepared By:
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Select date
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Floor:
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Area:
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Room/Corridor
Sump Pumps
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Sump Pits are clean and free of debris prior to setting?
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Picture of sump pit prior to installation
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Is entry to the pit required to install pumps?
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Has a work plan been developed?
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Has the safety department been notified of the confined space entry?
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Guide rails are installed and material is per submittal?
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Floats are installed at correct elevation and per detail?
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Coordination with electrician is complete, float and power cables are of sufficient length?
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Picture of power and float cables
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All O&M manuals that came with the pumps have been given to the PM to compile the turn over package?
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Manufacturers Rep has been onsite to assist with start up of pumps?
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Name of Manufacturers Representative:
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Date or Dates Rep was on site:
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Electrical/Control panel location has been coordinated and complies with electrical clearances required?
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Photo of Installed Panel
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Pit Lid matches frame and gasket and all bolts are installed?
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Picture of installed pit lid
Water Softener
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Anchorage complies with details?
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All Clearances required for maintenance or service have been addressed and adhered to?
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Photo of clear service area
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Flex connectors installed on connection to softener if required?
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Softening media installed if required?
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Manufacturers Rep has confirmed installation is correct and assisted in start up?
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Name of Manufacturers Rep
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Date or Dates Manufacturers Rep was on site
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Drains off equipment are run to floor sink and drain properly?
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Water softener installed on housekeeping pad if required?
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Photos of completed installation
Expansion Tank
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Anchorage complies with approved details
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Piping is installed to tank with union and valves as required?
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Piping is connected to cold water system per detail?
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Pre Charge Pressure of the tank has been confirmed?
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All O&M Manuals that came with the tank have been given to the PM for the turn over package?
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Tank is on housekeeping pad if required?
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Picture of completed installation
Domestic Water Heaters
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Piping to heaters complies with approved detail?
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All valves, gauges, reliefs thermometers are installed per detail?
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All Clearances for maintenance have been adhered to?
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Coordination with Electrical, Control, and Mechanical (steam) has been completed and clearances met?
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Anchorage of heaters is per approved detail?
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Housekeeping pad is installed if required?
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Flex connectors installed at equipment if required?
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Relief valves are run to floor sink?
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Manufacturers Rep has approved the installation and has assisted in start up?
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Name of Manufacturers Rep:
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Date or Dates Manufacturers Rep was on site
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Start up Documentation and compliance is complete and given to the PM?
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Insulation of equipment is complete if required?
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Picture of the completed installation
Circulating Pumps
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Circulating pumps installed per contract details?
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Pumps are properly supported?
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Picture of pump support
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Flex connectors installed if required?
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Aqua stat, timer and control panel installed?
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Timer and control panel are accessible and required clearances met?
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All O&M paperwork with with pumps has been given to the PM for the turn over package?
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Oil for bearings and seals has been installed if sent with pumps?
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Picture of completed installation
Thermostatic Mixing Valve
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Mixing Valve has been installed per the manufacturers instructions?
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Mixing Valve is supported properly?
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Picture of mixing valve support
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Mixing Valve is accessible?
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O&M Manual has been given to the PM for the turnover package?
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Picture of completed installation
Notes, Impacts, or Comments
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Notes, Impacts or Comments
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Signature of report preparer:
