• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Officers Name:

  • Support Officer:

  • WHS check completed

Storage Tanks

  • Are the storage tanks clear and have safe access?

  • Water Level in Tanks

  • Number of tanks with water in them.

Well / Pump Details

  • Were the Wells opened?

  • Pump 1 / LCW 3:

  • Time pump was inspected

  • Pump Box Satisfactory?

  • Pump 2 / LCW 2:

  • Time pump was inspected

  • Pump Box Satisfactory?

  • Pump 3 / LCW 1:

  • Time pump was inspected

  • Pump Box Satisfactory?

  • Are all Alarms ok?

  • Alarm / Camera Comments:

  • Pump & Sump - Leak near Pump 3 / LCW 1

  • Water Level:
    Leachate Status:
    Geofabric Condition:
    Trenches - Water level:

Treatment Cells

  • Is the Main power box secure?

  • Does the box need spraying for pests/bugs?

  • Notes:

  • North Cells Open?

  • South Cells Open?

  • Flow Meter reading:

  • Photo of North Flow meter

  • Photo of South Flow Meter

  • Treatment Pond

  • Treatment Pond TDS: Water Level: Condition of pond: i.e algae/plant levels

  • Is the submersible pumps clear/clean of algae/plants

  • Is the inlet for the mono pump clear/clean of algae/plants

  • Are the pump floats clear/clean of algae/plants

  • Notes:

  • Sewer flow meter

  • Is the Pond enclosure secure and safe/free from pest/bugs


  • Is there safe access to/around the wetland, including the outlet cage.

  • Notes:

  • Condition of Wetland Water level TDS: Algae/plant

  • Is the outlet secure with padlock and in closed position?

  • Notes:

  • Temporary Dam - Leak near Pump 2 / LCW 2

  • General site comments: <br>Access/overgrown<br>Status on leak/s<br>Overall site security/integrity of fencing<br>WHS issues/concerns<br>

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.